Many people are wary of back surgery, and for good reason.
Here are Sarah Key's non-surgical options for spinal stenosis treatment.
You will read in the page Make Sure You Have the Right Spinal Stenosis Treatment that advanced swelling of the facet joint is the most likely cause, particularly of transient stenosis symptoms.
With acute facet joint arthropathy (see Chapter 3 of the ‘Back Sufferers’ Bible’) the joint capsule becomes palpably engorged with trapped fluid that constricts the nearby spinal nerve root. The swelling is feel-able with human hands.
The general stasis of circulation makes the facet joint even less able to move to evacuate the fluid and this adds to the congestion and choking pressure on the nerve.
Acute swelling of the facet joint capsule can constrict the nerve root.
Adhesion formation in the chronic phase can add to stenosis symptoms
Symptoms of acute vertebral stenosis can be greatly helped by manual mobilising pressures via the thumbs. Through a combination of proprioceptive input (with touching pressure the brain decides to let go) and the direct physical kneading pressures there is rapid, palpable softening as fluid evacuates from the engorged capsule. During the treatment there may be pins and needles, fleeting ‘other’ pains in the back and/or the leg. No reason to be concerned; in fact it's a good sign.
With chronic facet joint stenosis the aim is to soften and stretch adhesions so they are reabsorbed by the blood stream. These have developed over years of repeated micro-trauma and inflammation of the capsule, just like chronic capsulitis of a frozen shoulder. The capsule weeps and then organizes into strands of living junk. In the spine’s case the adhesions bind the nerve to the side of the capsule and slowly strangles it.
Manual treatment must be purposeful with an expected treatment reaction - in some instances, a temporary stirring up of symptoms to more than they were. For more specific detail on this you can follow ‘Treatment for Chronic Facet Arthropathy’ in Back Sufferers’ Bible’
Adhesion formation is much more common than we imagine, particularly with chronic facet arthropathy. It can severely choke the nearby spinal nerve root
Two tennis balls in a bag are about the ideal distance apart to fit snugly over the facet joints either side of the spinous processes (the knobs you can see through the skin).
Position the tennis balls, or just one. over the problem facet joint, usually at L5 as shown here, or L4 about 1cm higher. You will know you're on the spot by the 'sweet' tenderness as you roll over it.
If you are in acute spinal stenosis and the joint is extremely tender, even to the slightest pressure, you can initiate treatment by simply pressuring the ball into the spot and rubbing for approximately 15-30 seconds. (Hard work for the arm!)
In the more chronic stages you can roll over on your back and lowering your weight onto the ball(s), let them pierce through the muscle bulk to the facet joint inside. It gives a shrill but agreeable discomfort. Move the ball around millimetre by millimetre until you find exactly the spot.
When you find the right spot, make tiny excursions rolling around on the ball, not being too vigorous or the muscle effort will flick you off the joint. Continue for 15-30 seconds once/twice a week only.
Squatting is an age-old way from pulling the facet joints apart and
relieving lower back pain
Squatting opens up the back of the spine around the facet joints and allows a better blood supply through to the spinal nerves. It provides almost instant relief. In the acute stage it allows trapped engorgement to evacuate.
Squatting during the chronic stage of spinal stenosis stretches adhesions and fibrosis of the posterior spinal structures and reduces the clutter growing around the nerve, like weeds invading a woodland. You can achieve a lesser stretch and lesser opening by simply sitting down, which is often necessary for relief while out walking.
Using the BackBlock is an essential part of spinal stenosis self-treatment. Apart from the passive hyper-extension (Step 1) the flexion part of the regime is also very important (Step 2 of the BackBlock regime) since it is this that most effectively ‘pulls apart’ the facet surfaces and helps the bloated joint evacuate fluid. This is critically important, just like carefully working free a swollen knee after injury, since the pressure of the fluid alone causes most of the knee’s discomfort. With vertebral stenosis, the flexion is best done in the unloaded position on your back on the floor, as per Step 2 of the ‘pressure change therapy’ (BackBlock) routine.
For more specific detail on this you can follow ‘Treatment for Acute Facet Arthropathy’ in Back Sufferers’ Bible’. Or, if you want to be absolutely sure you are getting this very potent and effective regime right, you are better off watching Sarah do it herself on video (see below). It adds to your confidence and efficacy to know you were doing it properly.
It's important that you know there can be ups and downs in taking yourself along your own journey of recovery from spinal stenosis. You cannot afford to stampede your back and you may have to endure lay-offs from treatment if things get too stirred up. You may even have to lay off using the BackBlock for 7-10 days if the pain is becoming less predictable. The main this is not to worry and not to panic!