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Spinal Stenosis

6/26/2014

2 Comments

 
Spinal Stenosis. Scary sounding isn’t it? More and more people are getting diagnosed with spinal stenosis every day and the rates of surgery are sky rocking. If you have spinal stenosis there are many questions that are running through your head like:
  • What causes spinal stenosis?
  • What treatments are most effective?
  • What choices do I have?
  • Is surgery the best option?

One of the most common explanations for “what causes stenosis?” was described by the Mayo Clinic:
“The main cause of spinal degeneration is osteoarthritis, an arthritic condition that affects the cartilage that cushions the ends of bones in your joints. With time, the cartilage begins to deteriorate and its smooth surface becomes rough. If it wears down completely, bone may rub painfully on bone. In an attempt to repair the damage, your body may produce bony growths called bone spurs. When these form on the facet joints in the spine, they narrow the spinal canal.”
They also explain herniated discs, degenerative changes to ligaments, spinal tumors can all lead to arthritis and degeneration. I can hear the little boy in Kindergarden Cop telling Arnold Schwarzenegger "it might be a tumor” and Arnold’s sharp reply:
The problem with these “causes” is that they are also symptoms, not the true source of the problem. We have to dig a little deeper. I like to start by asking more questions. Like:

  • If spinal stenosis is caused by osteoarthritis, what causes osteoarthritis?
    • Common answer is age. But that’s not true because than everyone who’s 60 or 70 would have it and they don’t.
    • Genetics is also a popular answer. Again common sense will knock this down because not everyone with the same genetics has osteoarthritis and not everyone with osteoarthritis has the same genes.
    • What else could cause it? Let’s think…
  • I hear people yelling “accidents and injuries!”
    • Oh, good answer, but…and that’s a BIG but…not everyone who’s had the same injuries or who’s been rear-ended develops osteoarthritis.
The answer to “what causes osteoarthritis?” can be found in the Mayo clinics description above:
“With time, the cartilage begins to deteriorate and its smooth surface becomes rough. If it wears down completely…”
The key words being “wears down.” What causes your car tires to wear down? What causes the soles of your shoes to wear down? What causes your brakes pads to wear down? Friction. We all know this. But we don’t often think about friction inside our bodies. Friction comes from movement right? So is the answer not to move? No. We (our spines included) are designed to move – move constantly every day of our lives. The problem isn’t that we are moving, but that we are moving incorrectly. This incorrect movement comes from our posture being compromised when we do move which increases friction in certain joints causing them to “wear down.”

Think about it like this: if your front right tire on your car keeps going bald it means your cars alignment is off. If you fix the alignment, that tire will last much longer and not continue to wear out prematurely.

All of us share the same basic design or posture. Since muscles move bones, compromised posture is a muscle problem. Use it or lose it. If we are not reminding our muscles of their job daily, these inactive, atrophied, and compensating muscles will alter the lumbar, thoracic, and cervical curves of our spine and affect the position of our load bearing joints (ankles, knees, hips, shoulders). Pete Egoscue describes how this happens in his book, Pain Free:
The muscles around the spine don’t all go at once. The rate of atrophy depends on the person’s lifestyle and working conditions, but gradually, as the body gets less and less stimulus from the environment, the magical S (curve of the spine) diminishes, taking with it the spine’s flexibility, load-bearing strength, and shock-absorbing capacity.
This can cause a multitude of problems including: back spasms, herniated discs, facet joint problems, degenerative disc disease, spondylolisthesis, spondylolysis, spondylosis, scoliosis, and spinal stenosis. In Pain Free, Pete Egoscue explains the typical medical approach to stenosis and his take on it:
The standard sugical remedy is to remove the lamina of the vertebrae – basically, one slope of the arch or ridge that runs along the posterior of the spine – enter the canal, and scrape away the calcium.

I have rarely seen a case of stenosis where this procedure was really necessary. Yes, there is calcium in the spinal canal, and there is nerve impingement. But if the lumbar, thoracic, and cervical curves are restored to a functional state, the spinal cord and branching nerve roots usually have enough room to operate without interference.
He continues:
In this and every circumstance that the body confronts, the old architectural slogan is absolutely right: Form follows function. Reintroduce proper design function, and the form – the structure – isn’t a problem. Back pain, no matter what it is called, is most often a symptom of a breakdown of form that has been generated by a loss of function…Whatever the contributing factors, a pain treatment that starts with function will rarely require you go after the body’s form.
In conclusion, spinal stenosis is caused by postural imbalances that leads to friction between vertebra. As this friction causes damage to the spinal structures, the body tries to repair the damaged area by forming bone spurs. Surgery only addresses the symptom of the bone spurs and/or degeneration, but not the cause of the spinal stenosis: postural imbalance. Properly designed Egoscue posture exercise menus from an Egoscue certified Postural Alignment Specialist and Advanced Exercise Therapist will help you restore function, correct your posture, and return to living a pain free and active life. 
2 Comments
vibha link
6/28/2017 05:03:05 pm

I have been diagnosed with severe lumbar stenosis with one or 2 protruding discs. The MRI image shows the spinal canal completely filled in with bone and thickened ligament, choking the nerves that go down the legs to the feet, probably causing my symptoms of leg weakness (no matter how much exercise I do), numbness in the feet and lower legs, back pain when standing straight and walking, and incontinence. The doctors say to get the surgery soon so it doesn't get worse - i.e. the nerves get damaged and I become paralyzed in a wheelchair. If I did your program, would the excess bone and ligament get resorbed? How long would that take approximately? Should I get the surgery and do the Egoscue exercises afterwards? Just wondering...

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Kay link
9/2/2018 10:10:05 am

Ive recently been diagnosed with the same situation only in the cervical area. Just curious if you opted for surgery or chose to do the Egoscue with results. Any advice would be appreciated.

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    About Matt Whitehead

    I'm an Egoscue Institute certified Postural Alignment Specialist (PAS) and Advanced Exercise Therapist (AET), certified personal trainer, PatchFitness performer, FiveFingers wearer, trail runner, mountain biker, dad, music lover, environmentalist, and wanna-be slam dunk champion. I will be providing you with the latest posture exercises to help you live, play, and be pain free.

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