A Pair of Serendipities Re: Spinal Stenosis

by Baxter

One fortunate thing about teaching a lot of yoga is that students are always coming up and asking me about interesting things that are happening with their bodies. And now our readers here at Yoga for Healthy Aging are also chiming in with intriguing questions about themselves and their students. (Thanks, by the way. We were hoping you would do just that!) Just last week, one such reader wrote in asking about a student with a condition called spinal stenosis. Then on Sunday, the final day of a three-day workshop I was leading in Billings, Montana (burrrrr…24 degrees), one of the students asked about his unusual back pain symptoms. On the list of possible causes that came to mind as he related his symptoms was spinal stenosis. With that, I decided to address this topic on our blog, as it is often, but not exclusively, a result of aging changes around the spinal column.

The condition is one that usually affects the lower back region of the spine, but can also be seen in the cervical or neck area as well. Backing up for a moment to relate some basic anatomy, the vertebral column or spinal column, your backbone, not only essential to our upright posture, but houses within it the spinal cord, or the extension of the brain that connects to the rest of our body. It descends down from the brain via the central canal all the way down to our sacrum bone. As it descends, it sends off nerves at every level of the bony spine to the right and left through small lateral openings called intervertebral foramen.

The Spinal Column

 According to the Cleveland Clinic, with age the spinal canal can narrow, resulting in spinal stenosis. The narrowing process, which is gradual, reduces the space available for the spinal cord and nerves. If only a small amount of spinal narrowing occurs, no pain will result. However, if narrowing continues, the nerves that travel through the spinal column to the legs become squeezed, leading to back and leg pain, numbness and leg weakness. And the pain and other symptoms are more pronounced with standing and walking, and often improved when sitting or lying down. So what does this have to do with aging?  Well, spinal stenosis occurs when bulging discs, arthritic spurs, and thickened tissues combine to "compress" the nerves traveling through the spinal canal or try to exit through the side openings, all of which are more likely to occur as we age. It typically occurs among older adults, and arthritis and injuries can also cause the spinal cord to narrow. I should note that there are also cases in which the condition can arise in much younger adults, but that is another discussion.

And short of strong pain medications and anti-inflammatory drugs, traditional physical therapy, and lastly, invasive surgery, what’s a person to do? Well, thanks to the use of yoga for a variety of back pain syndromes in several studies in the recent past, yoga is now recommended by the American College of Physicians and the American Pain Society as an alternative or complementary treatment.

That’s all well and good, but there are a lot of yoga styles and poses, and if you are already in pain from spinal stenosis, you might be just a bit hesitant to head off to your local gym or public yoga class. And, rightly so. It would better serve you to look for a specialty class that deals with back pain, or better yet, find a qualified instructor or yoga therapist who you could do some private sessions with you to determine which asana and styles of practice would serve you best. Two styles of yoga that have a stronger attention to good healthy alignment of the spine and body are Iyengar and Anusara yoga. Viniyoga or the yoga of Krishnamacharya are also therapeutically focused and designed to work one on one for your unique needs.

With that in mind, there are several recommendations I can make. If a particular group of poses worsen your symptoms, avoid them. If they improve or are neutral in effect, proceed with awareness as you do them. Because back bending tends to narrow the central canal, doing backbends when you have spinal stenosis is usually not recommended, but small amounts of back bending might be tolerated. The opposite movement, however, can often open the canal, so forward bends can be quite beneficial. And if the lateral openings are the issue, lateral side bends and twist away from the side of involvement can also be helpful.  Any poses that encourage a long, balanced spine and optimal posture are also worth practicing, such as Mountain pose, Staff pose, Downward Dog, and so on. And because reclining is often the position of relief for spinal stenosis, Legs Up the Wall pose and Savasana (Corpse pose) would likely end up as favorites.  Restorative practices and yoga nidra are also helpful, as they have the added benefit of calming the nervous system, which is usually on high alert in chronic pain conditions such as spinal stenosis.

Thanks to my students and you readers for today’s topic!