In this video I'm going to cover with you the 11 most frequently asked questions about
lumbar spinal stenosis, there's so much confusion about lumbar spinal stenosis
and what to expect from it as far as the symptoms, how soon is going to get better,
what it should feel like day in and day out, and what the long term situation is going to be like,
if you're suffering from lumbar spinal stenosis. I'm going to cover all 11 questions here next
before I do that, though, I just want to bring your attention to the description
below this video, I've got links to many of the questions that go much deeper into it and give
you more practical advice, exercises and tips, things that you can start to do right away.
To begin to help your lumbar spinal stenosis problem. I'm not going to go into all that in
this video as far as like showing you exercises. I'm just going to educate you in this video,
but you can go find exercises and stretches down below in the description. Or let's get on with it.
Question number one: Is lumbar spinal stenosis serious?
Now this answer is it depends. It really depends on how severe the stenosis is in your back. Now
there's two types of stenosis, you can have stenosis in the middle of the spine where the
spinal cord runs inside the bone. That's called Central stenosis. And then you can have lateral
stenosis, also called foraminal stenosis, where these nerves come out on the sides of the spine.
Those holes right there are the foramen, the Fremantle holes, and then they're also
called lateral stenosis, because it's on the sides or lateral to the spine. So you
can get compression on the nerves on the on the sides of the spine and within the spine.
Depending on how much pressure you have against the nerves. Because of how much narrowing
there's happening against the nerves that will dictate how severe your spinal stenosis is,
it often happens that we get people in our clinic here with back problems and leg problems,
and they've got to go get an MRI or an x ray, and they've been told that
they have lumbar spinal stenosis, it may not be clinically relevant.
In other words, it may not be the reason for your symptoms at this point. If you have an
MRI or an x ray, and then you discuss it with a doctor, and they've told you that it's more
moderate to severe, then it's probably a little more serious. If they're telling you it's severe,
and you have the classic telltale signs of lumbar stenosis, then it's definitely more
serious. And you're going to have limitations in how long you can stand how long you can walk.
Usually, you get an immediate improvement as soon as you sit down. That's how you know that your
symptoms are more stenotic or more like stenosis. And the farther along you are in this process,
then the closer you are to possibly needing a surgery in order to get compression off the spine.
Now, the most severe type of stenosis is central stenosis, where you're having
problems with your bowel and bladder control. In other words, you're peeing and pooping on
yourself uncontrollably. And this usually comes on kind of sudden for people sometimes it's it
is gradual. But it's hard to tell, especially if you're older and age like you're 6070s or older.
Because you might have other reasons for leakage or incontinence problems.
And if it's coming from the stenosis, it typically tends to come on kind of quick,
you do want to go get checked out by the doctor for your stenosis and see if that is contributing
to your incontinence problem. Because if it is, that means you need to go have a surgery on your
spine because you could get permanent loss of your muscles that control the flow of urine and feces.
So you want to make sure you keep all that inside yourself by keeping the nerves free that control
the muscles in your pelvic floor that hold everything in for the right time. If you're
in that situation where you have an accidents, go seek medical attention immediately. If it's a lot,
you need to go to the ER if it's just a little bit and it's controllable as far as incontinence,
then you probably need to make an appointment with a doctor and see
them this week or here in the next few days. I would not wait on this, you need to go get them
seen. Now if you don't have any of those severe symptoms that I'm describing, then your spinal
stenosis is not that serious, you still need to worry about it, I would still put some urgency to
fixing the problem and go figure out how to fix that by watching our videos we help with that.
The question number two: What happens if lumbar spinal stenosis is left untreated?
Well it progresses it progresses to like what I just talked about,
as far as getting the the nerves compressed so much that it's affecting your bowel and bladder
control. Now the stenosis itself can occur for many reasons it could be the discriminating it
could be the bones around the nerves growing like with bony overgrowth could be bone spurs.
It could also be the position of your spine that's compressing the nerves and allowing the bones to
shift within your spine that could be affected as well. The discs may lose their integrity in
other words, their position and their form. They may shrink as well they may get compressed and
that could affect the openings in the spine where the nerves pass, the longer that you go without
treating the root problem of spinal stenosis, which is usually related to muscle balance.
The longer that you go, the more this all progresses, and the more you're going to get
your spinal nerves affected, which translates to losses in certain functions, of course,
bowel and bladder like I just talked about. But I think the biggest impactful one is being able
to stand and walk as long as you like that, when that's affected, people are seriously limited in
going into the store being able to take care of themselves at home, and many of the things
that you would not expect. There's certain movements,
there's certain positions or certain exercises and stretches that are really bad. Generally,
anything that involves extension, like leaning backwards, bending backwards, there's therapists
out there that encourage patients to go backwards for certain back problems.
But lumbar spinal stenosis is one of those that you do know, you do not want to make
the back muscles stronger or bend backwards. In fact, I've got a video that talks about
some of the worst exercises and other things that you can do for lumbar spinal stenosis,
check it out in the description below. Question number four:
How does spinal stenosis affect the legs? Well, let me just show you real quick the anatomy
here, all these nerves that come out of the sides of the spine mucosa up here, right there.
Those nerves bundled together and travel kind of around the pelvis bones here, some go in front,
some go behind some turn into the sciatic nerve, some turn into the femoral nerve, and those
nerves traveled down the legs into the thighs, into the calf muscles, the lower leg muscles
and all the way down into the feet and toes. And so if you have compression of these nerves
up here, it's going to decrease the nerve signal to the muscles, it's going to decrease the nerve
signal to your skin to everything in your legs and that's what causes the weakness and numbness,
the pain of course, and tingling as well. There's some other symptoms that are less
talked about, like cramping. muscle cramping, is a common sign of compressed nerves, but people often
attributed to not having enough electrolytes in your system like potassium. But think about it.
If you're if your electrolytes are truly low, your muscles would cramp all over the place,
not just one side or one muscle group between both legs that is more common of a nerve problem.
Question number five: Is walking good for lumbar spinal stenosis?
Walking is generally seen as a very good thing for most health problems. But lumbar spinal stenosis
is one that I would proceed with immense caution if you cannot walk correctly, which is a whole new
thing to think about. For some people, the fact that you might be walking wrong. If you can't walk
correctly, you should not be walking for exercise to help improve your lumbar spinal stenosis.
Because if you're using the wrong muscles kind of alluding back to that muscle imbalance thing that
I was telling you about. If your muscles are out of balance, and you're using the wrong muscles to
do most of your motions, then walking for exercise is only going to make those muscles stronger,
the wrong muscles are going to get stronger and the muscles that you should be stronger in are
not being used, those are going to get weaker. So before you pursue walking for exercise, go fix
your walking pattern, which by the way, I've got a video specifically for how to improve walking
with lumbar spinal stenosis. It's also linked in the description below. That will teach you how to
walk properly so that you can now go walking and help the lumbar spinal stenosis problem.
Question number six: What is the best sleeping position for lumbar spinal stenosis?
Generally, a semi fetal position with your spine kind of supported your head kind of tucked in with
your body kind of curled them because the more you're an extension, the more pressure you're
going to put on your back. But the more you kind of bend yourself in and keep your hips
and knees bent, then that tends to take some of the pressure off your nerves. I actually have
a video for this as well check out the link in the description below for how to best sleep with
lumbar spinal stenosis problems. Question number seven:
Will I end up in a wheelchair eventually? This is a question I get that is just so it's
coming from a place of fear for people and just loss of hope. Because when they go to the doctor,
especially if they went and got an MRI or an x ray, doctors don't typically give people a
positive prognosis. You know, they don't tell them that this is going to get better. In fact,
they tell them you might need surgery one day, it's just going to get worse.
And you might end up in a wheelchair one day because your nerves that control your
legs are getting more and more pinched. And the poor patient that might be you you're feeling
the symptoms getting worse and your legs and you can't stand and walk as long as you were before.
So the natural progression of this that you would think is your legs are going to work and
you're going to end up in a wheelchair one day. I'm here to tell you that it is possible to
stop up the progression of lumbar spinal stenosis, I've got a video talking about that as is curable,
it's in the description below as well, it's linked down there. But it is possible to halt the
progression. Now if you're too far gone and you're already kind of in a wheelchair, you're just
avoiding walking completely because of problems. You might need surgery, there's other options.
This doesn't fix absolutely everybody, but there are things you can do to begin to
improve the pressures through your spine to take those pressures off your nerves,
which leaves the possibility for you to live a very normal life free of side effects
and problems from lumbar spinal stenosis as long as you fix the root underlying problem.
Question number eight: Does spinal stenosis hurt all the time?
For most people with moderate and mild and almost semi severe spinal stenosis, not the real severe
one, were they having like bowel and bladder problems in immediate pain once they stand
up. For the people that are not that severe, it typically doesn't hurt all the time, they can
usually find a comfortable position and feel fine. Now if they get into aggravating positions,
or they're doing activities that they shouldn't be doing, whether they know it or not,
then it can begin to flare up as far as their numbness, tingling, pain and weakness. And
one of the cool things about lumbar spinal stenosis is you get pretty immediate feedback
on whether what you're doing is working or not. Because if you're taking pressure off the spine,
you should find that you have improved symptoms when you're walking and standing. If your
symptoms aren't improving, then your situation might be a little too far gone. Or you might
need to get some extra help. It does often benefit people suffering from lumbar spinal
stenosis to get their joints freed up where they're stuck in their spine and in their
mid-back sometimes in their hip and pelvis area. The joints that are in there might be stuck and
contributing to increased pressures at the lumbar spine that can help to provide relief so that this
is not hurting all the time. And you're putting yourself in a situation where you can improve
the strength, improve the mobility of your spine joints and take pressure off for the long term.
Question number nine: What does Gabapentin do for spinal stenosis?
Gabapentin is a medicine a drug that physicians often prescribe for lumbar spinal stenosis.
It's a medication that's targeting the nerves. It helps with nerve related pain. Gabapentin
helps to decrease that pain and allow you to feel more comfortable it to walk for longer
and do more things. But it is just masking the problem it is not treating the root problem.
If you're looking to take Gabapentin for your lumbar spinal stenosis, that's fine, especially
if you need to do stuff and you need to continue with your life continue with your relationships.
But don't rely on the Gabapentin to fix your problem. It's not going to fix lumbar spinal
stenosis. It just prevents you from having the symptoms or it really just those are symptoms in
most people. It doesn't take them away completely. It just takes the edge off a bit so that they can
get through the day better. But you need to be working on that root problem. Because there are
side effects to Gabapentin most people feel kind of loopy feel kind of drugged. Some people have
no mental side effects whatsoever. And we don't know the full effect of Gabapentin on
your other organs, your liver, your kidneys, your organs that help filter this the stuff
that shouldn't be in your body out of the blood. Those are usually highly affected by medications.
Question number 10: What do injections do for spinal stenosis?
Well, kind of along the same lines as Gabapentin injections help to mask
the pain. Now they'll do injections on your spine, typically if you've got back problems,
but there are people that don't have back pain and have lumbar spinal stenosis and the leg weakness,
numbness pain and tingling down into the legs. And so they'll say when they come into the clinic
here, My back feels fine, little tight, but nothing like my legs. My legs are the worst
part of this problem. So if you're in that situation, you probably won't be offered
injections for your spine because injections don't take the pressure off your low back.
They are just designed to help with the pain and inflammation that people that do have back
pain with their lumbar spinal stenosis may opt to get injections to reduce the back pain here.
But it often doesn't change the pain down into the legs will still experience that. Number 11. Let me
get my helper to help me out here is What is the best current treatment for lumbar spinal stenosis?
Now if you're going to the doctor for this problem, they're going to offer you possibly some
medication like oral pain medication, if it fits your situation. They may offer injections, they'll
probably send you to physical therapy and see how you do there and add physical therapy you should
do your best to find a physical therapist or a clinic that specializes in helping people treat
lumbar spinal stenosis problems non surgically. Because most clinics out there for physical
therapy I can speak to this being a physical therapists myself, they specialize in helping
people after having had a surgery. And if they don't outright tell you that you can just walk
into the clinic, look around. And if you ask people to talk to the patients, ask them,
what are you here for, and they'll probably tell you that they had a surgery at least 60%,
if not more, will tell you that they're here for care after having had a surgery.
If that's the case, that clinic specializes in helping people after surgery, and they're
probably not going to be best suited to help you accurately and efficiently fix
a lumbar spinal stenosis problem or get the issues under control. So just be careful with
which clinic you go to and physicians don't know this information. So if your doctor,
even your orthopedic surgeon tells you to go to physical therapy, which is a great move by them.
By the way, it's still up to you to filter out which clinic which physical therapist is
going to be best to help you with your problem, that physical therapy doesn't work out for you,
they'll send you back to your doctor, your orthopedic surgeon, and the surgeon may
offer you a surgical solution for your problem. Usually, they'll do a laminectomy which is where
they cut off the back part of the bone. They may also offer you a fusion where they put rods
and screws into the bones and offload things and keep things from moving too much. But those don't
fix the root problem. As a specialist physical therapist, I specialize in helping people avoid
surgery, injections and pain medications. I'm looking at fixing the root problem of
lumbar spinal stenosis, which is usually a muscle imbalance. And the most common muscle
imbalance that I see in lumbar spinal stenosis is that the back muscles are too thick, they're
too stiff. They are compressing the joints and all the spaces where the nerves come out in the back.
They usually compress the discs as well because of the way that they pull. And so people often
have disc herniations associated with a lumbar spinal stenosis, and that's what causes the pain
going down into the legs. And in order to get that pressure off those back muscles and in turn
the joints and nerves in the spine, you need to start looking at the muscles that should be
doing the job of the stabilization for the back. And it's usually the abdominals in the front and
the glute muscles or the buttock muscles on the hips down here,
an exercise program focused on getting those two muscle groups stronger and not on getting any
more strength through the back muscles right here. That is a good exercise program and what I often
find in therapists that are trained in helping people prevent surgery, when it comes to back
problems. They're having people exercise their back problems, even when they get their lumbar
spinal stenosis patients and it tends to just progress the stenosis problem further.
Unfortunately, I've got a comprehensive program with coaching exercises,
stretches and tips on how to treat the root problem for lumbar spinal stenosis. It's
called the 28 Day Back Health And Wellness Boost Program. And it's 100% online and on demand. You
can learn more about it in the description below you anywhere you have the internet,
you can access this program and put yourself through a 28-day regimen of strengthening the
weakest muscles around your back problem to take pressure off the stenosis issues in your back.
And this helps to attack the root of the problem and make sure that you're on the track to truly
halting the progression of lumbar spinal stenosis. Thanks so much for watching this
I hope you learned a lot drop some comments below if you have any questions or if you just
want to say something if this stuff helped you out awesome if our other videos helped
you out comments on them to help us out. And by the way, my name is Dr. David I'm
a specialist physical therapist at El Paso manual physical therapy. And this channel is dedicated to
helping people like you avoid surgery injections and mitt and pain medications. And if you've
already had a surgery, we're looking to help you avoid the neck surgery because that happens often.
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videos we post every week. Thanks, and I'll see you the next video. Bye