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That's Good to Know- Spinal Stenosis Part 2

Things to STOP doing!!

In this article we discuss the importance of stopping certain activities, postures and thoughts. Not only is it imperative to do and think the right things to improve your spinal stenosis, it’s also important to understand why you need to stop other unhelpful movements, activities and thoughts. So here we go…

1. Stop sleeping on your stomach

When you sleep on your stomach, the space within an already narrowed compartment gets smaller. This creates more compression or pinching to the nerve and leads to more pain, weakness, numbness or other adverse symptoms. You could wake up feeling more back or neck pain and have a restless night if you choose to sleep on your stomach.

A better alternative is to sleep on your back with a pillow under your knees and a pillow that comfortably cradles and supports your head. Finding the right pillow is tricky. You want to look for one that keeps your head in line with the rest of your body…not too high and not too low.

If you are a side sleeper, the same rule of thumb applies to your head and neck. Keep the position of your head in line with your rib cage and pelvis and one that accommodates for the width of your shoulders. Also, a pillow between your knees helps keep your hips in alignment and minimizes the pull on your lower back. Of all the sleep position options, most experts will agree that the best sleeping position is on your back.

Weaning yourself from sleeping on your stomach can be frustrating if you’ve slept in this position for many years. One trick to begin the process is to use a body pillow. Place the body pillow in front of you and support your top arm and leg (as if you are hugging the pillow). This will give you support on your front side so it feels as if you are “almost” on your stomach.

This is called the Total Body Support Pillow. Use this link for more information:

Anther trick for stomach sleepers is to wear sleep pants and place a tennis ball in the pocket. When you turn over on to your front side, the tennis ball will remind you to flip back over!! ;)

2. Avoid prolonged standing.

Prolonged standing creates a lot of downward pressure on your body and if you have weakness in your core muscles, your hips and pelvis have a tendency to move out of proper alignment. We’ve all seen the person with his or her hips pushed out in front of the body. We call this “hanging on your ligaments.” Without getting too much in to the details of what’s happening in your hips, let’s just say it’s a very bad compressive, pinching posture for the lower part of your spine. And…make sure you don’t shift your weight onto one leg and stay there!! You’ve just taken a clamp to the nerves on that side of your back!!

Standing for a prolonged period of time isn’t good for your neck either. IF your head floats in front of your breast bone, or sternum, you’ll be clamping down on other important neck nerves. Maintaining proper head over shoulders, shoulders over hips, and hips over heels is a good rule of thumb for good posture. Even if you can stay in great alignment and posture while standing, the prolonged gravitational pressure on your spine causes a narrowing of your spinal canal reducing the space necessary for nerve tissues.

If you find it necessary to stand for a period of time, for example, standing in a long checkout lane, try these tricks:

• Alternate shifting your weight side to side

• Bend forward and round the spine as if reaching to touch your toes

• March in place

3. Stop treating only the pain and inflammation- You need to MOVE!! Spinal Stenosis is a progressive problem that needs proper movement to minimize the compression on the nerve tissues. Just concentrating on the pain and inflammation is not a well-rounded treatment plan. When the nerves are irritated, all the other tissues that send and receive information through the nerve pathway could be affected. So you might have weakness and stiffness of muscles, soft tissues and joints. Proper exercises are a must!! Most people respond best to exercises that focus on opening the spinal column and create more space for the nerve tissues. These exercises are frequently known as “Flexion” exercises or movements that bend the spine in a forward position (like bending forward to touch your toes).

A fabulous exercise for lumbar stenosis, that also feels good, is placing a foam roller or a firm pillow under your pelvis and drawing your knees to your chest. You can hold the position for several seconds/minutes and then start to sway your knees side to side. Not only does it feel good, but it helps to open and create more precious space for the lumbar nerves. Often the lower back tissues get very tight adding to the compression forces to the lumbar spinal bones. This extra pressure is adding to the gravitational pressure we feel with standing or bending backwards.


Not only does exercise reduce muscle tension and improve flexibility, it helps to move fluids throughout the body tissues. More fluidity means better circulation and less lactic acid build up. This is the chemical that creates soreness and tenderness in your body. It tends to get stuck in certain tissues and needs to be flushed out.

If you need help understanding the difference between a good exercise and a bad exercise, please seek out a medical specialist for a consultation. :)

4. Stop holding the phone between your shoulder and your ear!! If you have cervical stenosis (neck) holding your phone between your shoulder and ear creates a clamping down force on your neck. This pinches the nerves that cause pain down the arm. Also, check your posture while sitting at the computer and while using a tablet. Your chin should not float closer to the screen and your back needs to be straight, preferably supported by the back of the chair. Use a head set if you spend lots of time on the phone. This will save your arm and your neck.

See my blog on Text Neck:

5. Stop Bending Backwards.

Spinal stenosis is the over growth of too much bone, a too narrow canal, or other tissues crowding nerves. When you bend your spine backward or the process we call “extension,” there is a natural narrowing of the spinal canal. If you already have spinal stenosis, then bending backward could be making it worse!!

Sometimes reaching above your head causes back bending. Reaching for a dish out of an overhead cabinet creates an extension motion in the cervical (neck) and lumbar (lower back) regions of the spine. This extension “clamps” down on the sensitive and irritated nerves. Next time you think of reaching for something too high for you to reach, ask for help or go get the step stool. :)

A better movement for you is flexion. As discussed previously, flexion opens the spaces so the nerves are not compressed and irritated. Anything we can do to avoid increased pressure and irritation on these tissues will reduce pain, weakness and numbness in either the arms and/or legs.

For more information or to schedule a consultation, please contact me:

Dr. Rebecca Hoeck PT, DPT, CWC, CIDN, MPT-DMI®


The information contained on the site will not treat or diagnose any disease, illness, or ailment and if you should experience any such issues you should seek the advice and examination of your registered physician or practitioner as determined by your own judgment. You understand that the information contained on the site is not a substitute for health care, medical or nutritional advice of any kind.

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