Approach of physiotherapy in stenosis of the lumbar canal

What is a lumbar stenosis? What treatment options are there? How is it approached from the point of view of physiotherapy?

As explained by Physiotherapist in Dwarka, stenosis of the lumbar canal is defined as a narrowing of the diameter of the spinal canal due to morphological changes, which produces a compression of the neural elements that run through it. It can affect one or several vertebral levels.

The CAUSE of onset can be congenital (rare) or arthritic degeneration. Within the morphological changes that produce it, we can find:

• Hypertrophy of the bony or ligamentous system.
• Degeneration of the joint facets of the interapofisary joints.
• Spondylolisthesis.
• herniated discs.

The most characteristic SYMPTOM of stenosis of the lumbar canal is intermittent claudication, which we discuss below. Other clinical signs and symptoms may include low back pain (with or without irradiation to the lower limbs), loss of range of motion or sensations of paraesthesia or weakness.

Once the diagnosis has been confirmed by an orthopaedic in Delhi specialized in traumatology, with the help of imaging tests such as magnetic resonance imaging (MRI), the treatment approach can be conservative or by lumbar surgery.

Within the conservative treatment, physiotherapy in Dwarka plays a fundamental role in the reduction of symptoms, always bearing in mind that it is a chronic pathology. Depending on the intensity and severity of the symptoms, it can help to delay and, sometimes, avoid surgery.

Physiotherapic Treatment in A Patient with Stenosis of The Lumbar Channel.

The biomechanics of the lumbar spine produces modifications in the diameter of the spinal canal depending on the position of our lumbar spine. Thus, during the movement of trunk flexion this channel increases its diameter and during the extension movement decreases.

The intermittent claudication is caused by a further decrease of the diameter of the medullary canal due to compression of the circulatory system during prolonged running. This occurs because when we walk our lumbar spine is in an extension position (Lordosis), so the spinal canal is compressed. Pain and fatigue disappear when sitting, position in which our spine is usually more flexed.

The approach of this type of pathologies from the point of view of physiotherapy in Dwarka should include techniques and exercises that favor the movement of lumbar flexion, thus facilitating the increase in the diameter of the medullary canal. On the other hand, patient and physiotherapy doctor in Dwarka has to focus on the work which should be done to avoid favoring that the lumbar flexion may cause the appearance of other symptoms and to improve the general physical condition of the patient, thus allowing the improvement obtained to be perpetuated.

Therefore, rehabilitation should focus on performing mobilizations and exercises of lumbar flexion by both the best physiotherapist in Dwarka and the patient, such as:

- Work in pelvic retroversion.

- Bring the knees to the chest in the supine position, both simultaneously and alternatively.

- Lumbar flexion in quadruped.

- In a sitting position, bend down with your hands between your legs.

In addition, since part of the symptomatology has an important neural component, a neurodynamic work of the medullary canal and the peripheral nerves of the lower limbs will improve the adaptability of these tissues to their possible compression or elongation.

This should be combined with cardiovascular work (bike), strength and elasticity of lower limbs (MMII) and postural aimed at avoiding postures in hyperextension.