Unlocking Relief: 8 Targeted Exercises for Spinal Stenosis

Back pain is one of the most common medical problems. Although it is more frequent in seniors, it’s also not uncommon among physically fit individuals.

There are many causes of back pain — one of them is spinal stenosis. In addition to significantly impairing the quality of life, spinal stenosis also presents a substantial financial burden.

According to the review paper “Current Concepts and Recent Advances in Understanding and Managing Lumbar Spine Stenosis,” the total cost of spinal stenosis surgeries was almost $1.65 billion in 2007. (1)

But I have good news. Almost a decade of experience working with clients with different back problems has shown me that physical therapy and exercise can improve spinal stenosis. Surgery should be the last resort, as a proper exercise routine can solve pain and restore movement.

In this guide, I will go over the most effective exercises for treating spinal stenosis. I will also tell you how to ease the symptoms and what activities to avoid.

What is Spinal Stenosis?

The spinal canal serves as a protective space for the spinal cord and crucial components of the central nervous system. If this canal narrows, it leads to a condition known as spinal stenosis, resulting in compression of the spinal cord and nerves. This narrowing can occur in different parts of the spine, with the neck (cervical) and lower back (lumbar) being the most common areas.

Spinal stenosis causes various symptoms affecting mobility and overall quality of life.

The most common symptoms are:

• Chronic back pain (it may radiate to the arms or legs)
• Numbness, tingling sensation, and weakness in muscles
• Instability and difficulty walking or maintaining balance
• Loss of bowel or bladder control and sexual dysfunction in severe cases

Several factors contribute to the development of spinal stenosis:

• Degenerative changes associated with aging
• Wear and tear on the spine
• Herniated discs
• Bone spurs
• Genetic predisposition
• Injuries
• Tumors or abnormal bone growth

Besides age and genetics, there are other risk factors. Certain occupations involving repetitive spinal movements or heavy lifting might increase the risk, and this is a risk factor that every doctor will analyze. Osteoarthritis or rheumatoid arthritis can also be a cause, and although both genders can be affected, women develop spinal stenosis in the neck more frequently.

The diagnostic process must be comprehensive because other conditions, such as sciatica, muscle strain, and nerve damage, give similar symptoms. A thorough discussion of symptoms and a detailed examination of the patient’s medical history is necessary to avoid a wrong diagnosis.

Then, reflexes, muscle strength, and overall mobility are assessed before proceeding to MRI, CT scan, or another similar imaging method.

Finally, electromyography (EMG) is another helpful method to evaluate electrical activity in muscles and nerves, pinpointing areas of compression.

8 Exercises for Spinal Stenosis

A workout routine for relieving spinal stenosis must include exercises targeting different body parts.

A holistic approach is essential, focusing on strengthening the back, core, hips, and the entire body to prepare for a seamless return to regular activities.

Plank

The plank is a highly effective isometric exercise.

I like to call it a cornerstone of core strength since it engages multiple muscle groups simultaneously. There are numerous variations, but start with regular plank and add variations as you progress.

How To:

1. Get on your forearms in a standard plank position with elbows aligned under the shoulders.
2. Maintain a straight line from head to heels, engaging the core.
3. Hold the position for as long as it is comfortable, gradually increasing the duration.

Check out our complete plank guide!

Glute Bridge (with Stability Ball)

You must strengthen your posterior chain (lower back, glutes, and hamstrings), and the glute bridge is a great way to do it.

I usually introduce advanced variations of the glute bridge in my clients’ routines early in their training career. The instability element intensifies the engagement of the glutes and core.

Let’s make one thing clear — I don’t use an unstable surface to train healthy athletes. After all, why would you train on an unstable surface when you don’t play on one?

However, we should take advantage of the stability ball during rehabilitation. Clinical commentary “The Effectiveness of Resistance Training Using Unstable Surfaces and Devices for Rehabilitation” confirmed that this type of training is particularly beneficial for back pain. (2)

How To:

1. Lie on your back with feet on a stability ball, hip-width apart.
2. Drive your heels into the stability ball, lifting the hips towards the ceiling.
3. Hold the bridge position.
4. Lower the hips slowly.

Find more about glute bridge exercise in our comprehensive guide!

Straight-Leg Raises

Crunches are forbidden for all those with back problems, so we need a replacement exercise.

This spine-friendly movement targets the hip, quads, and lower abdomen muscles. You probably won’t have a full range of motion immediately, but that shouldn’t keep you from adding this to your exercise arsenal.

How To:

1. Lie on your back with your legs straight.
2. Lift one leg towards the ceiling, keeping it straight.
3. Lower the leg back down.
4. Repeat on the other leg.

More on this exercise in our separate guide!

Lateral Walk

This lateral movement helps you work on hip abductors and entire outer thighs. It’s a beneficial exercise for promoting hip stability and strengthening the muscles that support the spine.

The lateral walk, being low impact, is manageable for many individuals, even during the acute phase of spinal stenosis.

How To:

1. Put a resistance band around your ankles.
2. Take small steps to the side, maintaining tension in the band.
3. Repeat in both directions.

Isometric Squat (Wall Squat)

The isometric squat, also known as the wall squat, is a static exercise that targets the quadriceps, hamstrings, and glutes, making it suitable for individuals with spinal stenosis.

How To:

1. Lean against a wall with your feet hip-width apart.
2. Lower into a squat position, sliding down the wall.
3. Hold the squat position for over 20 seconds.

Pelvic Tilt

All the physiotherapists I spoke with agreed that pelvic tilt exercise must be an indispensable part of the workout routine of anyone with spinal stenosis.

This controlled movement improves strength and flexibility.

How To:

1. Lie on your back with your knees bent and feet flat on the floor.
2. Inhale.
3. Squeeze your core to flatten the lower back against the floor and tilt the pelvis upward.
4. Hold for a few seconds, then exhale and release.

Superman

I had problems with lower back pain for years (QL muscle was the culprit), and I can confidently say that this exercise helped me like no other.

The Superman exercise is a dynamic movement that targets the lower back, glutes, and upper back muscles. Your posterior chain will improve significantly if you do the Superman at least twice weekly.

How To:

1. Lie on your stomach with your arms extended overhead.
2. Lift both arms and legs off the ground simultaneously.
3. Hold the lifted position for at least 3 to 5 seconds.
4. Lower back down with control.

Find everything about this exercise in our dedicated Superman article. 

Fire Hydrant

You cannot have a strong back without a strong pelvic region. That’s why you need to do the fire hydrant.

And that’s not all. The fire hydrant is valuable for overall lateral strength and mobility, which is much needed in many sports.

How To:

1. Get on your hands and knees.
2. Lift one knee out to the side, keeping the hip bent at a 90-degree angle.
3. Hold for a moment.
4. Lower the leg back down and repeat on the other side.

You need more info? Go and check our dedicated Fire Hydrant guide.

4 Stretches for Spinal Stenosis

Stretching can promote flexibility, alleviate stiffness, and enhance overall spinal mobility.

After consulting with your physiotherapist or personal trainer, you can include many different stretches into your routine. In my experience, the following four stand out:

Towel Hamstring Stretch

While primarily aimed at the hamstrings, this stretch also relieves the lower back.

Using a towel will allow you to achieve this stretch gradually and with a lot of control, making it useful for people with different levels of mobility.

How To:

1. Sit on the floor with your legs extended.
2. Hook a towel around one foot, holding the ends with both hands.
3. Lie on your back, leg with a towel slightly bent and the other leg straight.
4. Lift the leg straight up and pull the towel towards you.
5. Keep the knee straight to feel the stretch in the hamstring.
6. Hold for 20 or more seconds.
7. Repeat on the other leg.

Kneeling Quad Stretch

The unpleasant feeling of tightness in your thighs is very common.

All four quad muscles originate at the pelvis, so tension in quads can affect the hip position and, thus, the spine. So, the quad stretch must be part of a comprehensive stretching routine.

How To:

1. Get in a half-kneeling position.
2. Shift your weight back slightly.
3. Reach back with one hand to grab the ankle of the foot on the same side.
4. Pull the ankle towards the glutes.
5. Hold for 15-30 seconds, maintaining an upright posture, and do not sway.
6. Change legs.

Child’s Pose

The child’s pose (Balasana) is one of the most important postures in yoga. Even beginners can do it to stretch multiple body parts.

The child’s pose primarily stretches the lower back, hips, and shoulders. I always recommend it to clients with back pain, regardless of the cause.

How To:

1. Start in a kneeling position with toes touching and knees spread wide apart.
2. Extend your arms forward on the floor and walk your hands away from the body to lower your chest to the floor.
3. Rest your forehead on the ground and relax.
4. Hold for 30 seconds to 1 minute, breathing deeply.
5. Slowly return to the starting position.

90/90 Stretch

90/90 Stretch is an incredible movement for both flexibility and mobility in different planes.

It will address tightness in the hips while minimizing strain on the spine. You will notice hip mobility improvement soon.

How To:

1. Sit on the floor with one knee bent at a 90-degree angle in front of you.
2. Place the other knee at your side, bent at the same angle.
3. Gently lean forward, hinging at the hips.
4. Hold, then repeat on the other side.

How to Ease Symptoms?

Exercises are key and, over time, will bring the desired relief, but there is no magic solution that will instantly solve all problems.

These tips will help you feel better:

• Use over-the-counter pain relievers like ibuprofen or acetaminophen to handle pain and inflammation. However, you must consult your healthcare provider before starting any new medication, training, or diet regimen.
• Temperature therapy is an excellent at-home treatment. You already have everything you need for ice and heat treatment. Ice packs can ease inflammation and dull pain during flare-ups. On the other hand, heat, like warm baths, relaxes muscles and improves blood circulation.
• Weight management is crucial since you must carry those extra 20 or 30 pounds with you 24/7. Excess weight adds stress to the spine, worsening discomfort.
• Buy comfortable shoes with adequate arch support for better alignment and reduced strain on the spine.
• Ensure quality sleep and proper lumbar support throughout the day. Investing in a high-quality mattress and an ergonomically designed chair is a must.

Activities To Avoid

While recovering from spinal stenosis, you must avoid certain activities at all costs. Otherwise, you will prolong recovery or even make the problem worse.

Engaging in these activities may worsen the condition to an extent where physical therapy and steroid injections are ineffective, and surgery becomes the sole alternative.

Contact Sports

The abrupt and forceful nature of contact sports, such as soccer or football, increases the likelihood of injury and spinal trauma.

High-Impact Activities

Recently, I had a client with spinal stenosis, and I told him to stay away from the local amateur basketball league he was playing in. However, I did not know that he also plays tennis regularly. He followed my advice for contact sports but did not think he should also avoid tennis. He came to the next training with more pain than in the previous month.

So, you have to avoid high-impact activities such as jumping and running on hard surfaces as well. Clay courts might offer some relief, but still, I wouldn’t recommend tennis and other non-contact sports until the symptoms subside.

Heavy lifting

Forget about heavy lifting in the gym until you strengthen your back with low-impact exercises. The same applies to heavy lifting in everyday activities. When lifting is unavoidable, think about your body position and mechanics to minimize tension on the spine.

Excessive Forward Bending and Twisting Movements

Excessive forward bending at the waist, such as certain yoga poses or exercises, can contribute to spinal compression and worsen pain.

Twisting movements, especially when combined with bending, will almost certainly exacerbate symptoms. That is another reason to avoid tennis, golf, or dance.

FAQ’s

Are there any recommended stretching routines for individuals with spinal stenosis?

For those dealing with spinal stenosis, it’s wise to consider gentle stretching routines. Direct your efforts towards the muscles around the spine, like the hip flexors, hamstrings, and lower back. Stay away from overly intense stretches, as they might worsen the situation.

Can acupuncture or massage alleviate spinal stenosis discomfort?

Acupuncture and massage therapy may offer some relief for spinal stenosis discomfort. While they can help ease muscle tension and induce relaxation, it’s important to note that these methods complement traditional treatments rather than being standalone cures.

How does stress management play a role in reducing the impact of spinal stenosis symptoms on daily life?

Stress management is pivotal in lessening the daily impact of spinal stenosis symptoms. Stress heightens pain, so relaxation techniques such as deep breathing or meditation can improve overall well-being. It’s about adopting a holistic approach alongside medical interventions to enhance your quality of life.

Can aquatic exercises be beneficial for spinal stenosis?

Consider adding aquatic exercises into your routine if you’re dealing with spinal stenosis. The buoyancy of water can significantly reduce strain on the spine. Engaging in activities like swimming or water aerobics improves strength, mobility, and flexibility without putting excessive stress on your back.

Can certain sleeping positions influence spinal stenosis symptoms?

Your choice of sleeping positions matters. Sleeping on your side with a supportive pillow between your knees, on your back, or under your knees can help maintain proper spinal alignment. Finding a position that minimizes discomfort is key, and seeking advice from sleep experts can provide valuable personalized insight.

Wrapping Up

When every movement is accompanied by pain, and you can’t do basic everyday things, it’s easy to lose hope.

But don’t despair because training is your ally. If you are persistent, chances are you will get rid of stubborn pain with non-invasive methods.

References

1. Bagley C, MacAllister M, Dosselman L, Moreno J, Aoun SG, El Ahmadieh TY. Current concepts and recent advances in understanding and managing lumbar spine stenosis. F1000Res. 2019 Jan 31;8:F1000 Faculty Rev-137. doi: 10.12688/f1000research.16082.1. PMID: 30774933; PMCID: PMC6357993.
2. Behm D, Colado JC. The effectiveness of resistance training using unstable surfaces and devices for rehabilitation. Int J Sports Phys Ther. 2012 Apr;7(2):226-41. PMID: 22530196; PMCID: PMC3325639.

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