Spinal canal stenosis of the cervical spine is often caused by degenerative (i.e. wear and tear), but congenital axial malpositions, vertebral deformities or acquired malpositions and overloading can also promote the occurrence of spinal canal stenosis in the cervical spine. In order to counteract the latter, but also to improve existing symptoms and achieve pain relief, physiotherapeutic exercises can help with spinal canal stenosis in the cervical spine.
Simple exercises to imitate
1. exercise – “Retraction” 2. exercise – “Static Flexion” 3. exercise – “Ground Pressing” 4. exercise – “Shoulder Circling “Spinal canal stenosis of the cervical spine leads to a narrowing (stenosis) of the spinal canal (spinal canal) and, as a consequence, often to symptoms such as pain in the shoulder neck area, motor and/or sensory deficits in the upper but also in the lower extremities, gait insecurity or a change in muscle tension in the extremities. Here our brain emerges as an extended medulla and runs as a spinal cord through the spinal canal to supply our body with nerves. If there is a narrowing, the nerves and blood vessels can be squeezed and suffer damage over time. This can lead to local complaints, but also to symptoms in the area supplied by the nerves. In most cases, the symptoms are less specific than those of a herniated disc, since it is not a specific exiting nerve that comes under pressure, but the spinal cord itself.
Physiotherapeutic interventions
Posture-correcting exercises are recommended to alleviate the symptoms of spinal canal steonitis in the cervical spine. In most cases, there are more symptoms when the head is placed in the neck or the chin is pushed forward. These are movements that cause the spinal canal to become even narrower.
The counter movement is called retraction.
- Retraction involves pushing the chin backwards, as if you wanted to make a double chin. The back of the head stretches straight upwards, the neck becomes long and the cervical spine straightens.
It is best to practice this movement in front of a mirror at the beginning, once you have mastered it correctly it is easy to perform and can bring relief to the compressed structures. When the chin is moved backwards, the position can be held for a few seconds and then slowly released. No fast, jerky movements of the cervical spine!
Do the exercise about 10 times slowly one after the other.
- To intensify the movement you can apply a slight pressure on the chin with your hands. This is best done with the gap between the index finger and thumb. Place this in the dimple under the lower lip and lift the forearm so that it is parallel to the floor (this avoids levering movements).
Now gently push the head further back in the movement, hold the position briefly (about 5-10 seconds) and then release. In everyday life this exercise can be used to quickly relieve the strain. At the desk, when you have looked at the screen with your head stretched forward for a long time, or in the car, you can push your head back against the headrest.
It is important to perform the exercise from an upright standing or best sitting position. You should only move your head, the torso remains stable!
- The double chin movement is also possible in the supine position. Here the weight of the head can also be removed, which provides additional relief.
On a firm base you take up the supine position and come to rest for a short time. Then you try to lift the gap between the cervical spine and the floor when lying down and press the spine into the support. This doesn’t quite work, but it makes it easier to imagine the movement and also the execution of the movement.
Again, the position must be held briefly (approx. 5-10 sec.) and then released again.
- If the retraction worsens the symptoms, it is the wrong direction of movement and the exercises are not appropriate.
Tilting the head forward can be pleasant, possibly with slow “no movements”, i.e. small rotations.
More exercises can be found in the articles: Since our spinal sections influence each other, exercises for the thoracic spine to maintain an upright posture (depending on findings) can also be helpful. In the case of motor deficits and sensitivity disorders, a symptom-oriented wide range of exercises can also be performed at home, which should be worked out individually in advance during therapy.
- To improve neck pain or pain in the shoulders, gentle stretching exercises can be helpful.It is important to avoid the movement that further constricts the spinal canal and thus aggravates the symptoms.
Shoulder circles, alternating, in the same direction or in the opposite direction, forward and backward, can also be pleasant. It improves the blood circulation in the shoulder neck muscles and can loosen muscle tensions. Cautious gentle movements with the head have the same effect.
The “in the neck laying” should be avoided, as it leads to a worsening of the symptoms in most cases. Slight rotations, i.e. looking over the right shoulder then over the left shoulder, or inclinations, placing the left ear up towards the shoulder, placing the right ear on the shoulder and gentle combination exercises are often very pleasant and relaxing.
- Spinal canal stenosis – exercises for at home
- Physiotherapy for spinal canal stenosis
In physiotherapy for spinal canal stenosis of the cervical spine, a precise diagnosis is first made to determine which direction of movement narrows the spinal canal even more (usually protraction and extension). This is followed by a postural finding to detect any incorrect posture and then to treat it specifically.
Other sections of the spine are also included, such as the thoracic spine, since its statics can also affect the cervical spine. The patient should precisely localize and describe his or her pain. Other limitations, such as loss of sensitivity, paralysis or muscle weakness, dizziness or gait insecurities are also analyzed.
A treatment plan and a common goal are established. It is important to note that even physiotherapy cannot widen the spinal canal, but can only alleviate symptoms through specific exercises, or provide relief in certain situations. An exercise program for home use is drawn up together with the patient.
Manual therapeutic techniques can also be applied. Often traction techniques are indicated for the treatment of spinal stenosis of the cervical spine. These are techniques in which traction is applied to the joints, the joint surfaces are easily released from each other, thus giving the structures more space and less pressure.
Many patients find this pleasant. Often a sling table is used for this purpose. Here, for example, the head can be held securely in a cloth sling while the physiotherapist performs certain techniques. Symptomatic treatment of muscle tension (massages, electrotherapy, heat, etc.) accompanies physiotherapy for spinal stenosis of the cervical spine.
