Description of Spinal Stenosis:
Herniated discs are often accompanied by a condition called spinal stenosis. Spinal stenosis is an abnormal narrowing of the central spinal canal or intervertebral foramen (lateral spinal stenosis). Central stenosis is narrowing of the central canal where the spinal cord travels. Lateral stenosis is the narrowing of the openings between vertebrae where the nerve roots exit the spine. This narrowing causes nerves to become compressed, either within the spinal cord or as the nerves exit the spinal cord.
Central spinal stenosis can be the result of spinal disc herniation, osteoporosis, osteophytic enlargement of the inferior articular process, congenitally decreased diameters of the spinal canal, and spondylolisthesis. Lateral stenosis is usually caused by a subluxation of the facets as a result of disc narrowing.
In general, spinal stenosis is caused by any condition which leads to narrowing of the spinal canal, but the most common is arthritis of the spine.
Spinal arthritis causes narrowing because it leads to the formation of bone spurs, thickening joint tissue (as a result of chronic inflammation), calcification of spinal ligaments and general degeneration of the spinal discs.
It is not common to find spinal stenosis in people under the age of 30. When younger people develop spinal stenosis it is usually a result of some kind of trauma to the spine.
Signs and symptoms of Spinal Stenosis
When spinal stenosis is present in the cervical spine, symptoms are often felt in the arms. If the area that is narrowing is in the lumbar spine, the symptoms are usually felt in the legs.
The most common symptoms of spinal stenosis include:
- back pain which is relieved by rest or flexing the spine
- spinal extension increases pain
- loss of bladder and bowel control (in severe cases)
Common medical treatments for Spinal Stenosis
Loss of bowel or bladder control is one of the more troublesome symptoms of spinal stenosis and is often treated as a medical emergency. When this occurs, medical professionals generally recommend immediate surgery.
Relieving the pressure on the spinal cord and nerves is the main purpose of any surgery related to spinal stenosis. A surgical procedure called a laminectomy may be performed to lessen the pressure on the spinal cord. This is most commonly performed in the lumbar spine. During this procedure, the lamina and spinous process of the vertebra are removed. Any other areas encroached upon by bone are also trimmed down.
Risks associated with surgery include infection, damage to nerves, tears in the meninges at the place of surgery and deep vein thrombosis. If a tear in the meninges occurs, cerebral spinal fluid can leak through the skin and lead to a infection. Arachnoiditis can also develop as result of a tear in the meninges.
Yoga therapy view — Chakra focal point of Spinal Stenosis
The focal point for chakra therapy for spinal stenosis will usually be on the area where the client feels the most discomfort. Since there is a narrowing of the spinal canal, it makes sense that the chakra or chakras may be deficient.
If the client is suffering from spinal stenosis in the lower back, visualizing the first three chakras speeding up on the inhale and slowing down on the exhale and/or expanding on the inhale and relaxing on the exhale might help. The same type of visualizations can be done for the heart and throat chakra if the spinal stenosis is located in the upper spine.
In general, most people suffering from painful conditions can benefit from visualizations and meditations focusing on the root chakra. Pain causes fear which causes more tension and so connecting to the earth and the universal self is always beneficial.
Meditation and visualizations where the client watches the chakras blossom one by one along the spine, immersing themselves in the color and nature of that chakra may also be helpful.
Yogic remedies for Spinal Stenosis
Yoga has the potential to improve vertebral alignment, increase range of motion and correct posture, all of which has the potential to slow down the progression of spinal stenosis. Backbends can close off the spinal canal further and may be contraindicated with central stenosis. However, this must be evaluated on a case-by-case basis as it is always beneficial to move within a pain-free range. Encourage your client to be mindful and approach back bending with caution if they suffer from central stenosis.
Side bending and twisting away from the painful side can open up the spaces between the vertebrae and reduce pressure on nerve roots in clients suffering from lateral stenosis.
For both types of spinal stenosis, inversions can help to reduce inflammation. Any poses that bring awareness to a lengthening of the spine in an isometric way such as mountain pose, tree pose, bound angle, and downward dog will usually be beneficial. However, it is particularly important in spinal stenosis to encourage the client to listen to their bodily signals. Any poses that aggravate symptoms can increase damage to the spinal nerves by causing inflammation.
Other poses that might be helpful include:
- half-moon pose
- child’s pose
- staff pose
- standing and seated forward bend
- happy baby pose
- wind relieving pose
Poses that might be contraindicated include:
- camel pose
- bow pose
- locust pose
- dancers pose
- knee down twist (and possibly all twists)
All types of massage could be beneficial for spinal stenosis. Care must still be taken not to aggravate any symptoms during Thai yoga massage by doing movements which are uncomfortable for the client.
Traditional Swedish massage can also be very effective in the reduction of pain caused by spinal stenosis. Massage can range anywhere from light, energetic enhancement to deep cross friction type movements. With this type of massage as well, the practitioner must be careful to avoid inflaming any joints as this can worsen symptoms.
During structural alignment therapy or while designing an exercise program for someone with spinal stenosis, it is important to remember that spinal extension usually increases pain and flexion of the spine reduces it. Rotation may also exacerbate pain and inflammation in some clients and in this case should then be avoided. However, this can vary from person to person and even from day to day. As long as you encourage the client to work through a pain-free range of motion, all movement is good movement.
In people who have had a laminectomy, stabilization poses are usually helpful in minimizing the postsurgical instability which is often expected.
A macrobiotic diet can help reduce inflammation and therefore the symptoms of spinal stenosis. Alkalizing diets are also popular for their anti-inflammatory properties. Although this diet is controversial and not everyone agrees with it, many people claim to enjoy tremendous benefits from following it.
The Alkaline diet is also known as the alkaline ash diet. It is based on the theory that certain foods leave an alkaline residue or ash after consumption. Minerals like iron, magnesium, calcium, copper and zinc are said to be the principal components of this ash. A food is classified as neutral, alkalizing or acidic according to the pH of the solution created with its ash and water.
Our bodies have an acid-based balance between 7.38-7.45. A more alkaline pH is thought to be healthier. An acidic pH is thought to slow down the healing process and provide an environment that has a tendency to promote to disease. In general, the diet involves eating vegetables, nuts, legumes, fresh citrus and low sugar fruits. Alcohol, mushrooms (fungi) cranes, dairy, meat and sugar should be avoided.
One of the most famous promoters of the diet is Dr. Robert Young who wrote the popular book “The PH Miracle”. He claims that a diet that is 80% alkaline and 20% acidic is ideal and can even reverse aging. By eating a diet that keeps the pH levels alkaline, the body does not need to use up mineral buffers and calcium stores. The diet has also been said to reduce inflammation, eliminate food sensitivities and restore us to our ideal weight.
There is also strong mind-body component to the alkaline diet. Positive emotions like love, faith, forgiveness and peace are said to have an alkalizing effect while negative emotions like anger, fear and resentment are said to have an acidic effect.
To learn more about yoga therapy for spinal stenosis and other injuries and illnesses, join our 200 hour Feel Good yoga teacher training program.