Spinal stenosis from standing is a topic of keen interest to patients with lumbar canal narrowing concerns and some patients who suffer from cervical and thoracic stenosis, as well. Standing is known to be a difficult activity for many spinal stenosis sufferers to perform. Furthermore, a great number of patients endure greatly exacerbated pain or neurological expressions when standing for any length of time. Standing and walking are basic activities of life. Being deprived of the ability to stand up is tantamount to suffering partial disability. For patients who must stand to work, their conditions usually force them to change careers or stop working altogether.
This informative commentary details the reasons why many spinal stenosis patients have trouble standing. We will also explore why pain worsens in the standing position.
Painful Spinal Stenosis from Standing
Spinal stenosis pain often begins or worsens when the patient stands for any significant length of time. This can occur regardless of where the stenosis resides, but is most often seen in patients with lumbar canal impingement conditions.
Standing really straightens the lumbar spinal region and can increase pressure on the cauda equina or spinal cord in the affected compressed levels. This escalated stress can be terribly painful and might create localized acute symptoms or radiating pain in the legs, often called sciatica.
Lumbar stenosis patients might also endure spasms in the lower back, buttocks, legs or feet when standing upright. These muscular constrictions are often linked to acute compression of nerve tissues, causing sudden loss of innervation to the affected soft tissues. These spasms can be terribly painful and debilitating, often forcing the patient to sit or lie down immediately.
Some patients with cervical or thoracic stenosis might also experience pain locally in the affected areas of the spine or in the lower body and legs. However, some patients will not experience any pain when standing, but simply will not be able to maintain an upright posture due to the neurological expressions examined in the section below.
Neurological Spinal Stenosis from Standing
Regardless of where the stenosis resides in the spinal anatomy, patients may experience a variety of neurological effects when they attempt to stand. These effects are usually the results of chronic spinal cord compression in the neck, upper back or middle back, or the result of chronic cauda equina compression in the lower back.
The most common patient citation for problematic neurological expression is certainly the inability to stand for long, or at all. Many patients have objective numbness and weakness in their buttocks and legs due to ongoing neurological compression. They may or may not feel pain.
Patients with this symptomology must be very careful, since they have a tendency to fall and might suffer grievous injury if they can not stand while positioned on a hard surface. Other patients might suffer highly specific neurological effects while standing, even if the position itself is not painful:
Some patients suffer urinary or fecal incontinence when standing. This expression can be just as debilitating as patients who can’t stand at all.
Some patients suffer subjective versions of numbness or paresthesia, often in the saddle area of the anatomy.
Some cervical stenosis patients might endure exacerbated headaches when standing or might experience dizziness or vertigo symptoms. These expressions might be worsened by movement of the neck while standing, as well.
Help for Spinal Stenosis from Standing
Not being able to stand for long is very limiting on a normal lifestyle. Patients might be able to stand for short time periods, but must have access to seats or beds to rest in between strenuous exertions. Not being able to stand at all is a major contributor to complete disability. Most patients will be forced to stay home and stop working. A minority might be able to continue in their chosen vocation, with considerable changes to their environment and work practices. However, most will lose their autonomy and suffer drastic financial losses that might endanger the welfare of their family.
While these experiences are horrible, at least they are predictable and can be planned for and accommodated. Sometimes, the worst expressions of standing-related stenosis symptoms are those that are only occasionally suffered in unpredictable patterns. These are the patients who can be injured severely when they fall unexpectedly. These are also the patients who develop the most fear from their symptomology, since they never know when an acute episode might strike them down.
To learn more about what can be done to combat stenosis that is escalated from standing upright, talk to your physician or physical therapist for case-specific advice and recommendations.