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Physical Therapy for Spinal Stenosis

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Your doctor may refer you to a physical therapist to help relieve your pain from spinal stenosis and restore movement. Whether you have surgery or not, physical therapy may be a key to your healthy recovery.

Physical therapy includes both passive and active treatments. Passive treatments help to relax you and your body. They also prepare your body for therapeutic exercise, which is the active part of physical therapy.

Your physical therapist may give you passive treatments such as:

  • deep tissue massage: This technique targets chronic muscle tension—tension in your low back (lumbar spine) that perhaps builds up through daily life stress. The therapist uses direct pressure and friction to try to release the tension in your soft tissues (ligaments, tendons, muscles).
  • hot and cold therapies: By using heat, the physical therapist seeks to get more blood to target the area because an increased blood flow brings more oxygen and nutrients to that area. That helps your body heal. Cold therapy slows circulation, helping to reduce inflammation, muscle spasms, and pain. Your physical therapist will alternate between hot and cold therapies.
  • Transcutaneous electrical nerve stimulation (TENS): You could even use this at home, if your therapist thinks it's necessary. A machine stimulates your muscles through variable (but safe) intensities of electrical current. TENS may increase your body's production of endorphins, your natural painkillers. The TENS equipment your physical therapist uses is larger than the "at-home" use machine. However, whether large or small, a TENS unit can be a helpful therapy. But keep in mind that TENS is not recommended for chronic pain. In fact, a 2009 study from the American Academy of Neurology found that TENS units are not effective at treating chronic low back pain.1
  • ultrasound: By increasing blood circulation, an ultrasound helps reduce muscle cramping, swelling, stiffness, and pain. It does this by sending sound waves deep into your muscle tissues, creating a gentle heat that enhances circulation and healing.

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In the active part of physical therapy, your physical therapist may show you exercises to help you build and maintain strength, endurance, and flexibility for spinal stability. Some of these exercises will help strengthen your abdominal muscles since they help support your back—and yes, it will be more than doing sit-ups. Your physical therapist will create an individualized program, taking into consideration your health and history. Your exercises may not be suitable for another person with spinal stenosis.

Updated on: 01/23/13
Jason M. Highsmith, MD
This article was reviewed by Jason M. Highsmith, MD.
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