Don’t treat the MRI, treat the pain.
Why this matters:
The term stenosis means “narrowing”. That’s it. Spinal stenosis means that there is narrowing in the spine; but where? The canal? Foramina? Where is there a narrowing and why is it causing my pain? Narrowing of any opening results in more chances that the nerves can get pinched. REsearch has shown that MRI’s have little correlation with identifying the source of pain. As a result, we need to see how the pain behaves clinically. This means, what activities make the pain feel better or worse?
What makes it even more challenging is that you can have spinal stenosis and a herniated disc. The exercises designed to treat spinal stenosis are also the same exercises that are designed to make herniated discs worse. This is extremely confusing and if we were to treat just the MRI findings, then there is a huge opportunity missed.
So what do we do? We investigate clinically to understand what the cause of pain is.
Take a look at this video to have a visual understanding of spinal stenosis.
If your pain improves with forward bending, you have permission to forward bend. Stenosis might be the cause of your pain.
If your pain improves with back bending, you have permission to do that motion. You might be dealing with a herniated disc.
You are not your MRI. If it didn’t detect cancer or a fracture, it did its job.