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Exercises for chronic conditions: lumbar stenosis.(EXERCISE RX)

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| March 01, 2005 | Nagler, Willibald | COPYRIGHT 2005 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

Lumbar spinal stenosis occurs in the lower back, where most back movement takes place. The condition develops when osteoarthritis causes a narrowing of the opening in the vertebrae through which the spinal nerves pass. In some advanced cases, bones press on the spinal nerves when the body is in a certain position or positions, which causes a sharp pain.

Symptoms of this condition are similar to those of disk disease; patients may complain of numbness in the legs and pain in the lower spine. Older patients may report shooting pains in the legs when they first wake up in the morning.

Patients with lumbar stenosis may report that walking seems more difficult although they have no apparent pain in their knees. They also may find that their calves hurt after walking but that the calf pain goes away when they sit down. These symptoms are due to a combination of body position and tight muscles that further close off the already narrowed vertebral openings. When the patient sits down, the openings become slightly enlarged, which may reduce the pain temporarily.

Lumbar spinal stenosis is often mistakenly diagnosed as sciatica, peripheral vascular disease, or simply the aches and pains of old age. It tends to develop with age and is more common among people who have worked in a physically demanding job, such as construction, for most of their adult lives. The condition will become more common among the population in general as people live longer.

One way to diagnose lumbar stenosis is a treadmill test, but not the kind you would use for a heart examination. Have the patient walk on a level surface, and then change it to an incline. While walking uphill, patients with spinal stenosis can experience pain relief, but patients with peripheral vascular disease tend to have more severe pain.

In this month's column, we'll look at some exercises to help relieve the discomfort of lumbar spinal stenosis. (See illustrations and instructions for patients below.)

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