Exercise Methods for Lumbar Spinal Stenosis

Due to the differing pathological foundations of lumbar spinal stenosis (LSS) and lumbar disc herniation, their exercise regimens also differ. Patients with lumbar disc herniation primarily focus on lumbar extension exercises, whereas LSS patients prioritize lumbar flexion exercises.

Principles of Exercise for Lumbar Spinal Stenosis

The key principle is to minimize lumbar extension and maintain a slight forward-bending posture, as extending the lumbar spine further reduces the volume of the spinal canal, compressing the nerves. This can lead to lower back pain, as well as leg pain or numbness.

Resting Posture: Unlike lumbar disc herniation patients who may use a pillow under the lower back, LSS patients should lie flat on their back or side. Occasionally, a thin pillow under the pelvis can help maintain a slightly flexed lumbar posture.

Walking Posture: Use a walker or cane and keep a slightly forward-leaning posture during walking.

When unsure how to proceed, follow the basic principle of choosing movements that feel comfortable and reduce pain. If exercises exacerbate back or leg pain, consult a doctor for professional advice.

Recommended Exercises

Supine Position (Knee-to-Chest Roll):

Lie naturally on your back. Bring both knees toward your abdomen as much as possible while hugging them with your hands. Perform gentle rocking movements side to side.

Key Points: Bring your knees close to your abdomen without causing discomfort. Keep the rocking range gentle and controlled.

Seated or Standing Forward Bend:

In either a seated or standing position, place your hands in front of your body and bend forward, aiming to touch the ground with your hands.

Key Points: Do not overly focus on touching the ground. Perform the movement to a comfortable depth without causing pain.

General Guidelines

Avoid overemphasizing the number of repetitions for each movement. Instead, prioritize consistency and gradual progression.

Regular, frequent practice is more effective than sporadic efforts.

If any exercise worsens pain or causes discomfort, stop immediately and seek medical advice.