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I have been told that my leg pain is caused by spinal stenosis. What I'm wondering is why does the pain get worse when I try to stand up straight?
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Lumbar spinal stenosis (stenosis of the low back) is a common cause of back problems in adults over 55 years old. Spinal stenosis describes a clinical syndrome of back, buttock, and/or leg pain. It is a condition in which the nerves in the spinal canal are closed in or compressed.
The spinal canal is the hollow tube formed by the bones of the spinal column. Anything that causes this bony tube to shrink can squeeze the nerves inside. As a result of many years of wear and tear on the parts of the spine, the tissues nearest the spinal canal sometimes press against the nerves.
In the lumbar spine, the spinal canal usually has more than enough room for the spinal nerves. The canal is normally 17 to 18 millimeters around, slightly smaller than a penny. Spinal stenosis develops when the anteroposterior diameter (front-to-back measurement of the canal) shrinks to 12 millimeters or less. Stenosis can also occur when the transverse diameter (side-to-side opening) is less than 15 millimeters.
Irritation or a decreased supply of blood to the nerves is the main cause of the painful symptoms, numbness, and weakness. Postural changes (like flexion) can help reduce the compression of nerves and blood vessels in the spinal canal. As you bend forward, the spinal canal widens. As you straighten up or even extend backwards, the spinal canal gets narrower.
Even with spinal stenosis, it's important to maintain an upright posture. Keeping the chest open gives the heart, lungs, liver, and other organs contained within the chest and upper abdomen room to function without being compressed. It also reduces the shearing force and abnormal load on the vertebral bodies that can lead to vertebral compression fractures.
Physical therapists can help with this problem. They can apply pain-reducing measures while helping you maintain your full height. Gentle soft tissue and spinal mobilization along with specific exercises are usually part of the program. The goal is to widen the spinal canal and take pressure off the spinal nerves.
It is important to improve the strength and coordination in the abdominal and low back muscles. Your therapist can also evaluate your workstation or the way you use your body when you do your activities and suggest changes to avoid further problems.
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