by Baxter
One fortunate thing about teaching a lot of yoga is that students are always coming up and asking me about interesting things that are happening with their bodies. And now our readers here at Yoga for Healthy Aging are also chiming in with intriguing questions about themselves and their students. (Thanks, by the way. We were hoping you would do just that!) Just last week, one such reader wrote in asking about a student with a condition called spinal stenosis. Then on Sunday, the final day of a three-day workshop I was leading in Billings, Montana (burrrrr…24 degrees), one of the students asked about his unusual back pain symptoms. On the list of possible causes that came to mind as he related his symptoms was spinal stenosis. With that, I decided to address this topic on our blog, as it is often, but not exclusively, a result of aging changes around the spinal column.
The condition is one that usually affects the lower back region of the spine, but can also be seen in the cervical or neck area as well. Backing up for a moment to relate some basic anatomy, the vertebral column or spinal column, your backbone, not only essential to our upright posture, but houses within it the spinal cord, or the extension of the brain that connects to the rest of our body. It descends down from the brain via the central canal all the way down to our sacrum bone. As it descends, it sends off nerves at every level of the bony spine to the right and left through small lateral openings called intervertebral foramen.
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The Spinal Column |
According to the Cleveland Clinic, in some people the spinal tunnel through which your spinal cord travels from brain to body (your spinal canal) can begin to narrow with age. This is called “spinal stenosis.” As the canal gradually narrows, it can start to press in towards your spinal cord and the nerves within the canal. If the narrowing is minimal, there may be no symptoms. But at a certain point, if the canal actually presses the cord and/or nerves, it can cause a variety of symptoms in your lower back and legs, from pain to numbness and tingling to muscle weakness. Typically the pain and other symptoms are more pronounced with standing and walking, and often improved when sitting or lying down. So what does this have to do with aging? Well, several conditions that occur more commonly with aging can contribute to the development of spinal stenosis, including arthritis and arthritic bone spurs, herniated or bulging discs, and general thickening of the tissues in the spinal canal. And it is usually a condition of older adults, although there are rare occurrences in younger adults that I won’t address here.
And short of strong pain medications and anti-inflammatory drugs, traditional physical therapy, and lastly, invasive surgery, what’s a person to do? Well, thanks to the use of yoga for a variety of back pain syndromes in several studies in the recent past, yoga is now recommended by the American College of Physicians and the American Pain Society as an alternative or complementary treatment.
That’s all well and good, but there are a lot of yoga styles and poses, and if you are already in pain from spinal stenosis, you might be just a bit hesitant to head off to your local gym or public yoga class. And, rightly so. It would better serve you to look for a specialty class that deals with back pain, or better yet, find a qualified instructor or yoga therapist who you could do some private sessions with you to determine which asana and styles of practice would serve you best. Two styles of yoga that have a stronger attention to good healthy alignment of the spine and body are Iyengar and Anusara yoga. Viniyoga or the yoga of Krishnamacharya are also therapeutically focused and designed to work one on one for your unique needs.
With that in mind, there are several recommendations I can make. If a particular group of poses worsen your symptoms, avoid them. If they improve or are neutral in effect, proceed with awareness as you do them. Because back bending tends to narrow the central canal, doing backbends when you have spinal stenosis is usually not recommended, but small amounts of back bending might be tolerated. The opposite movement, however, can often open the canal, so forward bends can be quite beneficial. And if the lateral openings are the issue, lateral side bends and twist away from the side of involvement can also be helpful. Any poses that encourage a long, balanced spine and optimal posture are also worth practicing, such as Mountain pose, Staff pose, Downward Dog, and so on. And because reclining is often the position of relief for spinal stenosis, Legs Up the Wall pose and Savasana (Corpse pose) would likely end up as favorites. Restorative practices and yoga nidra are also helpful, as they have the added benefit of calming the nervous system, which is usually on high alert in chronic pain conditions such as spinal stenosis.
Thanks to my students and you readers for today’s topic!
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Thanks for the superb post. I'm so intrigued by spines. Great info!!!
My student in a chair yoga class has spinal stenosis. Her experience is right in line with your post. She finds a lot of relief from a simple forward bend while seated. This is one of our standard warm-up moves. Bending at the hips and not at the waist, lean forward and rest the chest on the thighs. Overweight people can spread the knees apart to make a little more room for the belly. My student says she does this several times a day and it feels good.
Joanne
You have written quite a bit about breath, which is both interesting and helpful. I am wondering about ujaya breath (sp?), which I learned about from my first yoga teacher (kripalu). We used to do this when holding more difficult poses, but I am not sure of why this breath is seen as important, and would like to know more about it
Thanks for your feedback Mimi.
Joanne, it's good to know your experience is in line with Baxter's post.
migratoryme, we will address your question in a future Friday Q&A post, I promise.
–Nina
–Nina
Hello, I found this article very helpful and appreciate your information. I have a student who just started my class at a community college who has spinal stenosis which as described here can be relieved by mindful forward bends. However, she also tells me she has osteoporosis (all on an intake form) which from my understanding is an indication to avoid forward folding. My class is very large and is beginners yoga, and I plan on talking with her about self monitoring and awareness, emphasis on hip hinge for forward folds, however I am wondering if you have any other thoughts in that these two conditions exist in one student simultaneously. In her early 60s,he is very motivated to be in my class…