Does Exercise Help with Spinal Stenosis?

Key points in 30 seconds

1. Exercise doesn't widen the narrowed passage.
2. But it does help increase how far you can walk.
3. Bending the lower back backward narrows the passage further.
4. Resting before it gets hard and then walking again increases your total distance.
5. If your legs lose strength or you have trouble with your bladder or bowels, a surgical consultation comes first.

What we often hear

• "After walking just a little, my legs go numb and I have to sit down before going on."
• "It's a bit better when I push a cart at the supermarket."
• "They tell me to exercise, but I don't know what to do or how."

Does exercise help with spinal stenosis?

Exercise can't widen the narrowed space. But exercise really does help increase how far you can walk and lengthen the time between rests.

There's a reason we make this distinction first. When people hear "treat it with exercise," they expect the narrowed passage to widen. That doesn't happen. What changes is the conditions under which the nerves pass through that narrow space.

What exactly is spinal stenosis?

Inside the spine is a passage that nerves run through. When that passage narrows and presses on the nerves, it's called spinal stenosis.

Think of a drainpipe. When debris builds up inside the pipe, water can't flow through well. In the spinal canal, too, bone and ligaments thicken and the space the nerves run through narrows.

Why do I have to stop and rest while walking?

Because walking upright narrows the passage further, while sitting or bending forward widens it. So even when walking gets hard, sitting for a moment lets you walk again.

"I have to stop and rest after about 3 minutes of walking" and "it's a bit better when I bend forward" are typical of this condition. It's also why you feel fine when sitting or lying down.

This feature is what guides the choice of exercise. Movements that bend the lower back backward narrow the passage further, so we avoid them, and use movements that bend the lower back slightly forward along with exercises that support the trunk.

What should I do at home?

The basics are exercises that build up the deep core muscles and movements that loosen the stiff buttock and back-of-thigh muscles. For walking, set rest intervals and walk in segments.

Stopping walking altogether actually shortens the distance you can walk. Instead of walking until it's hard and then collapsing into a seat, it's better to sit and rest before it gets hard, then walk again. Even walking the same 30 minutes, splitting it up increases the total distance.

Which movements suit you differs from person to person. A movement that makes your leg numbness worse afterward isn't the right one for you.

What are the limits of this judgment?

We don't have data comparing which exercises are best for spinal stenosis. What's written here are principles that come from the nature of this condition.

One more thing. If the distance you can walk is quickly getting shorter, your legs are losing strength, or you have trouble controlling your bladder or bowels, a surgical consultation comes first. That's not a situation to get through with exercise.

Before recommending exercise, we first measure how far you can walk now. Even the same exercise is prescribed differently depending on how many minutes you can walk.

If you've been told to exercise but don't know what to do, come see us. We'll start by deciding what you can do in your current condition.

How well exercise works differs from person to person, depending on how narrowed the space is and how well you can walk.