Spinal Stenosis


Pathophysiology

Spinal stenosis generally occurs in those aged over 50 years as a result of osteoarthritic change to the vertebrae and decreased disc height causing a narrowing of the spinal canal. This narrowing can then irritate the nerves passing around it and cause symptoms such as numbness, tingling and weakness.

Symptoms

  • Leg pain and weakness in the legs, may also have numbness or pins and needles in the legs
  • Can be one leg or both
  • Symptoms worse with prolonged walking or standing
  • Symptoms usually relieved by sitting or bending forwards

Management

  • Activity modification and pacing
  • Ice or heat
  • Pain relief- in discussion with GP may be able to consider antineuropathic medication such as amitriptyline or gabape ntin
  • Physiotherapy including range of movement exercises and a graded strengthening programm
  • Orthopaedic of surgery if unresolving- likely to improve buttock and leg pain but may not improve low back pain

Investigations

  • MRI may be appropriate if symptoms do not improve with conservative measures after 3-6 months if wishes to consider surgery

Exercises to try:

seated flexions

Seated Flexion

Sitting on a chair or on the edge of your bed

Feet hip width apart

Place your hands on your legs and slowly slide your hands down towards your toes and back up again







Knee Hug

Knee Hugs

Lying on your back

Bring one knee up towards your stomach

Hold with both hands, fingers interlocked and pull in and out gently





Knee Rolls

Knee Rolls

Lying on your back with knees bent and feet together

Gently take both knees from side to side 

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