Cervical spinal stenosis exercises are vital components of most of the physical therapy programs that are typically prescribed for patients with canal impingement issues in the neck. Exercise therapy can be helpful for many types of back and neck pain diagnoses. Physical therapy is ideal for helping patients to recover from injury or from surgical intervention. However, there is also a darker side of physical therapy. In many cases, exercise therapy is prescribed when it holds no hope of curing the underlying structural issues which are causing the pain. In these circumstances, the recommendation for formal physician-assisted exercise regimens are usually made to increase care profitability or to qualify the patient to receive ever-more invasive treatments, such as a spinal operation.
This dialog examines the usefulness and limitations of exercise therapy for patients with spinal stenosis in the neck.
Cervical Spinal Stenosis Exercise Usefulness
For rehabilitation purposes, neck exercises are great. They help to rebuild muscular strength and soft-tissue flexibility. If a patient has already been treated surgically for cervical stenosis, then physical therapy is exactly what they need to fully recuperate.
Even for active stenosis symptoms that have not been successfully cured, exercise might help to maintain the normal range of motion in the neck and preserve muscular strength that might otherwise be lost due to a fear of painful movement.
These are very beneficial aspects of physical therapy, but one must question if less formal exercise could not achieve the same ends, if not provide even greater relief, without the cost and inconvenience of professional PT. Therefore, informal exercise must be judged as well, including walking, swimming, yoga and Pilates and any other practice that can be enjoyed without the assistance of a physician or PT assistant.
Statistically, informal exercise seems to fare just about as well for providing targeted benefits and does so without the aforementioned costs, schedule restrictions or escalation in care that is so common to the modern physical therapy arena.
Limitations of Exercises for Spinal Stenosis
Exercise is great for the body and crucial for the mind. A person can not really be truly healthy without getting enough exercise in life. However, when used as a curative therapy for active stenosis conditions, any logical mind would question the purpose and potential efficacy of exercise treatment, before it even begins. After all, stenosis describes a narrowing of the inside of the spinal canal. This space can not be made more patent by performing any type of exercise.
Some would argue that particular positions might help some specific forms of stenosis, such as those that are enacted by atypical curvatures and some intervertebral disc pathologies. Of course, these outspoken exponents of exercise therapy would be right. That being said, placing a patient in a beneficial position for a few seconds, or even a few minutes, will have no bearing on the degree of stenosis when they return to a normal anatomical state. Therefore, the most that can hope to be achieved is a few moments of decreased symptomology, at best, while ironically, most patients will never even enjoy this relief due to the exertion and pain of the actual exercise itself.
In summary, how can any exercise, no matter how perfectly it is done, or how many times it is repeated, be expected to reshape the interior of the cervical spinal canal? Except in the most extreme examples of uncommon curvature-enacted or disc-based stenosis, exercise simply can not and will not accomplish this goal of providing a cure. Furthermore, citing a huge volume of patient reports, many PT exercises often escalate pain, both during and after the session.
Cervical Spinal Stenosis Exercises Editorial
I know this article comes off as being anti-exercise, at least when used as a spinal stenosis treatment. However, this is not the intention or the meaning. The main point to take away from this essay is that exercise is highly unlikely to provide any semblance of a cure for cervical spinal stenosis. It will not resolve the condition, no matter how many therapy sessions are attended. More importantly, exercise is not even designed to cure stenosis in the neck.
Sure, this seems obvious to some of us, but not to all. You might be amazed at how many patients write to us with the same story. It usually goes something like this: “I have been going to physical therapy for over eight months. I do all these painful exercises, but I still have spinal stenosis in my neck. How long is it going to take for me to become cured?”
What? No one bothered to tell these poor souls the truthful limitations of exercise therapy. This seems like a convenient and purposeful oversight in most cases, in order to extract the most money from each paying customer. We have no problem with allowing any physical therapist to help a stenosis patient to achieve improved physicality and maintain flexibility. These are both crucial aspects of good health. However, we have a real problem when the patient is not honestly told of the expectations of said treatment. This presents a serious ethical problem in our book.
Furthermore, health insurance plans that require conservative care options to be exhausted, before qualifying a patients for a potentially life-saving spinal operation, are unenlightened and wasting everyone’s time and money. Since PT stands virtually no hope of providing a cure for true stenosis and surgery is likely to provide relief, why not just get on with it? This is yet another confounding scenario that we see day to day, expressed in the utter frustration of your many letters and emails.
Cervical Stenosis Exercises Conundrum
We certainly do not mean to point fingers here, particularly at physical therapists. If you read our sites regularly, you will surely know that we have great admiration and respect for these healers, possibility above all others. However, the science of PT is not a heal-all, and for stenosis, it really does come up short in providing curative results.
If you are a stenosis patient who is in exercise therapy, or has been recommended for exercise therapy, be sure to ask your care providers to what end is this prescription being made. Demand answers that make sense and have the doctors put the prognosis for the expected results in writing.
For patients who want to exercise, but have endured bad experiences with PT, there are still many benefits that you might be able to find during your own pursuit of great physical fitness. Talk to your doctor about swimming, tai chi, yoga, walking, bike riding and many other non-impact activities that can make positive changes in the anatomy of the neck, without the cost or inconvenience of medical exercise therapy.