Spinal canal stenosis is usually seen in older patients who have degeneration in their spine. Patients with minor spinal canal stenosis may experience little or no symptoms. As the condition progresses, symptoms can include low back pain and stiffness. In more severe cases involving spinal cord compression, pain, pins and needles, weakness or numbness may be experienced by the patient in the lower back, legs or feet.
Usually, patients with spinal canal stenosis experience an increase in symptoms during activities that straighten or extend the spine repetitively. Symptoms may also increase during activities that place weight on the spine (eg. lifting, prolonged standing, etc). Symptoms tend to ease during activities that bend the spine (e.g. sitting) or take weight off it (e.g. lying).

Investigations such as an X-Ray, CT scan or MRI are usually required to confirm diagnosis of spinal canal stenosis.

Patients with spinal canal stenosis are generally managed well with an appropriate treatment program. While little can be done to reverse the degenerative changes to the spine, patients can often remain active by modifying their activities. The primary goal of treatment is to remain as active as possible without aggravating symptoms in order to maintain strength and mobility and to avoid deterioration. Activities should be balanced ideally to prevent any increase in symptoms. A gradual increase in activity and exercise can occur provided symptoms do not increase.
Alternative exercises placing minimal force through the spine should also be performed to maintain fitness provided they do not increase symptoms.

Treatment for patients with spinal canal stenosis is important to assist with pain relief, improve flexibility and strength, and to ensure an optimal outcome. This may comprise:

• soft tissue massage
• mobilization
• traction
• acupuncture
• education
• activity modification advice
• exercises to improve flexibility, strength and core stability.

The spine comprises of many vertebrae, each of which has a large hole in its centre. Because these bones are situated on top of each other, their holes line up, forming the spinal canal. This canal provides protection and space for the spinal cord nerves to travel from the brain to the rest of the body. Each vertebra connects with the vertebra above and below via two types of joints: the facet joints on either side of the spine and the disc centrally (figure 2).
Occasionally, the spinal canal can become narrow. This is normally associated with ageing or osteoarthritis and is due to gradual wear and tear of the bones, joints, and discs. When this occurs, it is known as spinal canal stenosis. As the condition progresses, the narrowing may place pressure on the spinal cord resulting in a variety of symptoms.

Despite appropriate chiropractic management, some patients with spinal canal stenosis continue to deteriorate. When this occurs, other intervention may be required. This may include pharmaceutical intervention, investigations such as an X-ray, CT scan or MRI, or assessment from a specialist. The treating practitioner can advise on appropriate management and can refer to the appropriate medical authority if it is warranted clinically.

The following exercises can help with spinal canal stenosis. You should discuss the suitability of these exercises with your chiropractor prior to beginning them. Generally, they should be performed 3 times daily and only provided they do not cause or increase symptoms.

1) Rotation in lying – Lie on your back, knees bent, feet flat and together. Gently take both knees from side to side as far as possible without increasing your symptoms. Repeat 10 times.

2) Knees to chest – Lie on your back, knees bent. Take both knees towards your chest as far as possible without increasing your pain. Use your hands to take them a little further provided your symptoms do not increase. Hold for 5 seconds and repeat 10 times.