“I have spinal stenosis. Will exercise help?”

Spinal Stenosis is a narrowing of the spinal canal or opening where the spinal cord resides and where the nerve roots exit. Depending on the severity of stenosis and the clinical symptoms I have seen many people improve with Physical therapy and decompression type exercises. Since every persons condition and pain is highly variable, some people will show great improvement while others minimal or no improvement. I often consider that the musculature of the core and spine are in a weakened state or conversely may be overly tight or contracted. These conditions both contribute greatly to individual symptoms therefore must be addressed. The type of exercises that benefit this condition most are deep abdominal strengthening and flexion type exercises. The abdominals function to 'decompress' the nerve roots as they exit the foramen and therefore relieve radiating-type symptoms. Flexion exercises however are not indicated if there is also a history of osteoporosis or compression fractures. There is no 'cook book' approach here but an individualized exercise program tailored to each person is the best advice.
I hope you will consider mobility, strengthening, and conditioning exercises before you agree to undergo surgery.

I highly recommend trying physical therapy. It is an easy conservative approach that has great outcomes with spinal stenosis, especially depending on the severity. Once you get cut you can’t undo it. All the best, I hope you feel better.

Have you tried dry needling and other PT modalities for pain relief?

The goals of any physical therapy treatment plan are to reduce pain, increase function and provide a maintenance program for back pain and sciatica. Typically, the treatment plan is comprised of two components-active exercises and passive modalities. The exercise regimen may consist of strengthening, stretching and aerobic conditioning. Core muscle training is also a part of a good lower back pain treatment plan. It’s important that these exercises are done properly and consistently.

Passive modalities used in a physical therapy treatment plan for back pain and sciatica may include heat and cold therapy, ultrasound and transcutaneous electrical nerve stimulator (TENS) units. Heat and cold therapy are used to reduce muscle spasm, inflammation, and pain. With ultrasound, deep heating is applied to the soft tissues through sound waves. It is known not only to help relieve pain but to enhance healing. A TENS unit uses electrical stimulation to override pain signals sent to the brain. If it is successful, a TENS unit can be used long term.

All around, research has proven that physical therapy is effective for those who suffer from back pain or sciatica pain. It’s also safe. That’s why the Centers for Disease Control and Prevention (CDC) highly recommends it. “Physical therapists partner with patients, their families, and other healthcare professionals to manage pain, often reducing or eliminating the need for opioids. Research has shown that a simple education session with a physical therapist can lead to improved function, improved range of motion and decreased pain.”

A Physical Therapist is well educated in how to prescribe exercise for your condition, as well as in which interventions to use to decrease your pain. So, yes, I do think seeing a PT would be wise. As far as "needing" surgery, only you can be the judge. I usually tell my patients that they need to explore all conservative options before agreeing to surgery, which makes permanent changes to your body. Surgery is not 100% effective.

Yes, whether or not you choose to have surgery, physical therapy before and after is key to your success.