Use Exercise With Physical Therapy to Treat Lumbar Spinal Stenosis (2024)

Exercises for spinal stenosis focus on changing the position of your spine to help take the pressure off of the spinal nerves. This can help to decrease your pain and improve your overall mobility.

This article describes a step-by-step spinal stenosis exercise program similar to one that your physical therapist may prescribe. It focuses on restoring normal mobility to your spine.

Before starting any spinal stenosis exercise program, check with your healthcare provider to be sure that the exercises are safe for your specific condition.

What to Expect from Spinal Stenosis Physical Therapy

Sustained Lumbar Extension

Some people with spinal stenosis may benefit from bending backward, although it was traditionally thought to be avoided. It is theorized that an extension position gently presses against the softlumbar discs and nudges them away from your spinal canal. This can help give your lumbar nerves a little more room.

To perform the sustained lumbar extension exercise:

  1. Stand with your feet shoulder-width apart.
  2. Support your back and bend backward.
  3. Hold the position for about 60 seconds.

This position may cause an increase in your back pain, as well as leg pain or tingling. If these symptoms subside within 60 seconds, this exercise can be added to your lumbar spinal stenosis home program.

If sustained lumbar extension causes an increase in your symptoms that does not resolve within 60 seconds or so, it should be eliminated from your home exercise program.

Lumbar Extension and How It Helps Back Pain

Lumbar Flexion in Lying

Use Exercise With Physical Therapy to Treat Lumbar Spinal Stenosis (1)

To start your spinal stenosis lumbar flexion exercise progression, perform the flexion in lying exercise. To do this exercise:

  1. Lie on your back with your knees bent.
  2. Slowly bring your knees up to your chest, and grab onto them with your hands.
  3. Hold this balled-up position for two seconds.
  4. Release your knees back to the starting position.
  5. Repeat 10 times before moving on to another exercise.

Williams Low Back Flexion Exercise

Seated Lumbar Flexion

To perform the seated lumbar flexion:

  1. Sit in a firm chair with both feet on the floor.
  2. Slowly bend yourself forward and reach toward the floor.
  3. Hold the fully bent position for two seconds. If you need to deepen the stretch, grasp your ankles and give a gentle tug.
  4. After holding the position for two seconds, release and return to the full, upright seated position.
  5. Repeat 10 times and then move on to the next exercise.

10 Things to Stop Doing If You Have Low Back Pain

Standing Lumbar Flexion

Use Exercise With Physical Therapy to Treat Lumbar Spinal Stenosis (3)

Standing lumbar flexion is a great exercise for individuals with spinal stenosis. To do the exercise:

  1. Stand with your feet apart.
  2. Slowly bend yourself forward, reaching towards the floor.
  3. When you are fully bent, hold for two to three seconds.
  4. Slowly return to the upright standing position.
  5. Repeat the exercise 10 times.

This exercise can be used to help reduce back pain, as well as leg pain or tingling that may come on while you are out for a walk.

Standing Lumbar Flexion for Low Back Pain

Hip and Core Strengthening

If you have spinal stenosis, core strengthening exercises can help improve the way the muscles that support your spine work.

The posterior pelvic tilt is a great exercise that works your abdominal and hip muscles while flexing your spine.

To do the pelvic tilt:

  1. Lie on your back with your knees bent.
  2. Slowly roll your pelvis backward as if youwere flattening out your spine. Hold this position for 3 seconds.
  3. Slowly return to the starting position.
  4. Repeat 10 times.

Sometimes, hip strengthening may be in order to help you improve your walking ability. For example, you could start with basic straight leg raises and then move on to advanced hip strengthening exercises. Your physical therapist can help you decide which exercises are best for your specific condition.

How to Do a Pelvic Tilt

Aerobic Exercise

Use Exercise With Physical Therapy to Treat Lumbar Spinal Stenosis (4)

Lumbar spinal stenosis is a progressive condition that comes on gradually. With worsening symptoms, you may decrease your aerobic activity level.

Work with your healthcare provider to manage your spinal stenosis symptoms so you can start to incorporate aerobic exercise into your routine, such as:

  • Walking, which is an effective intervention for those experiencing back pain
  • Biking, which places your spine in a stenosis-friendly flexed position and is an appropriate alternative if your symptoms prevent you from walking any distance

Exercises to Avoid With Spinal Stenosis

With spinal stenosis, you should avoid high-impact exercises that involve running and jumping because of jolts to the spine. This includes contact sports like football or soccer. Low-impact exercises like swimming are OK. Ask your therapist about trying both extension (bending back) and flexion exercises (bending forward) to strengthen the spine.

Summary

If you have lumbar spinal stenosis, exercise may be used to treat your symptoms and help prevent the progression of the condition. Visit your physical therapist to learn exercises specific to your condition, so you can start your lumbar spinal stenosis home exercise program as soon as possible.

6 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. American College of Rheumatology. Spinal stenosis.

  2. Tousignant-laflamme Y, Longtin C, Brismée JM.How radiological findings can help or hinder patients' recovery in the rehabilitation management of patients with low back pain: what can clinicians do?J Man Manip Ther. 2017;25(2):63-65. doi:10.1080/10669817.2017.1309345

  3. Stewart DM, Gregory DE. The use of intermittent trunk flexion to alleviate low back pain during prolonged standing. J Electromyogr Kinesiol. 2016;27:46-51. doi:10.1016/j.jelekin.2016.01.007

  4. Chen C, Lin Z, Zhang Y, Chen Z, Tang S. Does the effectiveness of core stability exercises correlate with the severity of spinal stenosis in patients with lumbar spinal stenosis?. Pak J Med Sci. 2017;33(3):631-634. doi:10.12669/pjms.333.12123

  5. Vanti C, Andreatta S, Borghi S, Guccione AA, Pillastrini P, Bertozzi L. The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials. Disabil Rehabil. 2019;41(6):622-632. doi:10.1080/09638288.2017.1410730

  6. Pauwels C, Roren A, Gautier A, et al. Home-based cycling program tailored to older people with lumbar spinal stenosis: Barriers and facilitators.Annals of Physical and Rehabilitation Medicine. 2018;61(3):144-150. doi:10.1016/j.rehab.2018.02.005

Use Exercise With Physical Therapy to Treat Lumbar Spinal Stenosis (5)

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.

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