FACEBOOK.COM/WDDTYAUNZ ISSUE 01 | AUG/SEP 2019 | WDDTY 53
HEALTHY LIVINGsuch as sitting for long periods of time are
inherently compressive for the spine, some
people with spinal stenosis may not be aware
of its presence or experience any symptoms.
As you can see from the bottommost diagram
on page 41, modern postural patterns that
deviate away from our ideal alignment
can create compression in various forms,
depending on individual tendencies.Signs of spinal stenosis
Pain that is relieved by
rest or bending forward,
where the spine is
flexed, and worsened
by spine extension or
bending backward,
could signal spinal stenosis.
Other signs are tingling,
numbness and muscle
weakness.
When stenosis
affects the cervical
spine (neck),
symptoms are
usually felt in the
arms, and when in
the lower back,most often in the legs. Symptoms can worsen
over time, with loss of bladder and bowel
control in the most severe cases involving the
lower back.
The conventional medical view is that
there’s no cure for spinal stenosis, and spinal
‘decompression’ surgery may be offered.
Usually, this will involve a laminectomy,
which removes the lamina—the posterior
(back) part of a vertebra (spinal bone)that covers your spinal canal. This is most
commonly performed in the lumbar area
(the lower back).
The surgery essentially enlarges the spinal
canal to relieve pressure on the spinal cord
or nerves, but according to a 2017 review,^1
it comes with a significantly greater risk of
complications compared to physical therapy
programs. Risks of surgery include recurrent
or continuing symptoms, infection, blood
clots, leakage of cerebrospinal fluid, nerve
injury, paralysis and loss of vision.
Patients are also routinely offered
high-dose pain medication for the
inflammatory effects that create
chronic pain in the back and legs,
as the nerves feeding down into
the legs are impinged, although
this pain can often be caused by
muscle imbalance and not the
stenosis per se (see WDDTY May
2019).
Physiotherapy may be advised to
help increase the spinal range of motion
and ensure that sufferers do not avoid
movement, which they often do because
of the pain. Further loss of range of
motion can worsen symptoms.
The myofascia (muscle and
connective tissue) in all areas of
the body—including around
the spine—need constant
motion to bring in
nutrients and oxygen,
as well as remove
waste products
fromthroughoutthe body. This keeps tissues
hydrated and less prone to adhesions (fibrous
bands that form between tissues and organs)
or hardening, which can add to inflammation
and transmit pain to other areas too.
A reliance on pain medication can worsen
the situation, as it not only reduces beneficial
gut bacteria and encourages inflammation,^2
but also masks the pain, which could
otherwise inform us how best to move.The importance of balance
Those with spinal stenosis have been
historically recommended to only bend
the spine forward, putting it into flexion.
This was believed to relieve nerve
pressure by increasing the diameter
of the spinal canal. However, moving in one
direction without the balance of the opposite
restricts full motion of the body.
The exercise sequence described on the
following pages includes some gentle back
bending, because although deeper back
arches can put too much pressure onto discs
that may be herniated (closing the spinal
canal further), gently pressing in that area
can move nerves away from the spinal canal,
offering them more space and helping to
relieve compression.
Balance is important too. Encouraging
healthy posture with natural spinal curves
relies on balance between the front and back
body, so becoming aware of both of those as
you open the spine front and back can also
help inform the way you move in daily life.
Ultimately, if you can feel uplift through the
spine whenever possible, there is less nerve
impingement. Strengthening the muscles
that support the spine upward also creates the
space that relieves compression.Exercises for relieving
spinal compression
The following exercises are mostly isometric
in nature—where muscles contract but don’t
actually move, i.e, they hold you in place with
muscle fibers activated but with equal forces
working against each other.
This creates a strengthening effect and,
without the exertion of movement, also allows
you to breathe fully and does not contribute to
any stress response, which fires off protective,
inflammatory reactions.
The most important guide within
these exercises is to listen
and respond to what feels
right for your body❝
Modern postural patterns such as
sitting for long periods are inherently
compressive for the spine
❞