Spinal canal stenosis - when the spine becomes narrower

Pain when walking, numbness in the legs, the need to constantly bend forward: spinal stenosis is a typical symptom of old age - but anything but harmless. It restricts you, makes you feel insecure and changes your posture - both physically and mentally.

What is spinal canal stenosis?

In spinal canal stenosis, the spinal canal narrows - where the spinal cord and nerve roots are actually well protected as they make their way through the spine. The lumbar spine is most frequently affected. However, the cervical spine can also be affected.

What leads to constriction?

• Degenerative changes such as disc wear, spondylophytes (bone growths), thickened ligaments or arthritic facet joints

• Instability due to muscular weakness or segmental incorrect loading

• Postoperative or post-traumatic changes

The result: the nerve roots have too little space - pressure, inflammation and irritation occur. And you can feel it.

Typical symptoms - the "intermittent claudication of the back"

• Pain when walking, especially downhill or when standing upright

• Improvement when sitting or leaning forward

• Feeling of numbness, tingling, weakness in the legs

• Sometimes also bladder or bowel dysfunction (red flag!)

The clinical picture often resembles PAD ("intermittent claudication"), but is neurogenic - i.e. caused by nerve compression and not by circulatory disorders.

Why conservative therapy often makes more sense than a scalpel

Of course, there are surgical options - especially in the case of pronounced neurological deficits. But not every constriction needs an operation.

Patients benefit much more frequently from a targeted, individualized therapy concept:

1. clarification

Understanding takes the pressure off. Those who know that prevention leads to relief use it consciously - without fear. Education reduces pain avoidance and catastrophizing.

2. stabilize & relieve

The aim: to build dynamic stability. Strengthen abdominal and back muscles, stretch hip flexors, improve range of motion.

3. learning to walk - with strategy

Instead of long walking distances: intermittent exercise, e.g. with short breaks while sitting or bending forward. In therapy: practice walking, increase resilience, analyze gait pattern.

4. mobilize without irritating

Gentle mobilization of the spine, fascia work, emphasis on breathing. Aim: maintain mobility, reduce pain, promote nerve gliding.

What patients need: structure, patience and good support

Many come with fear: "My back is broken", "I can't move any more". Others have already had surgery - and still have complaints. Still others "just want the injection".

Therapy here means: Awakening hope without sugarcoating. Giving orientation, allowing the body to feel again - and building trust step by step.

Conclusion for therapists:

• Spinal canal stenosis is not a surgical verdict, but a call for active support.

• The joy of movement instead of a relaxed posture.

• Communicate safety - through education, clear exercises and realistic goals.

• Therapy is not a sprint. But those who accompany rather than instruct will see progress.