Some of my older clients sometimes describe to me how their legs get really achy, heavy, and sometimes tingly or numb when they’re out walking. One lady was recently describing this to me, and commented “Funny thing is, I can shop for hours in the supermarket with no problem!” This is a situation called “neurogenic claudication” – or, as I now term it, “Shopping Trolley Syndrome”! It happens when the bony tunnel inside the spinal column gets narrowed, as it sometimes does with age (this is called “spinal stenosis”). As the lower back is arched, during walking for instance, this narrowing can compress the small blood vessels which supply the nerves as they exit the lower spine to go into the legs. This means the nerves can’t function properly, and causes pain, tingling and heaviness in the legs. People who get this feeling find it goes away if they round out their lower back – this opens out the spine and helps the blood flow. They can do this by leaning forward or sitting down (or maybe perching on a wall if they’re out and about). For this reason, people with spinal stenosis sometimes find it easier to walk uphill rather than on the flat, and can walk further pain-free if they’re leaning on something like a lawn-mower – or a shopping trolley!
Spinal stenosis is a structural change to the spinal column, and can’t be “cured” by manual means – in severe cases, the best approach is surgery which aims to widen the spinal canal to allow more space for nerves and blood vessels. Milder cases can be managed with therapy, though. I work to stretch the back, tummy and hip muscles which can compress and bend the spine like a spring if they’re too tight. Gentle mobilisation to encourage the spine to flex well can also help ease symptoms. Then I look at other parts of the spine and the hips, knees and ankles – if these aren’t working well, the lower back may be having to work too hard. I also give advice on self-care, such simple exercises, and adjustments to everyday activities. The shopping-trolley-lady now stands at her ironing board with one foot up on a low stool (and can get through quite a pile of clothes this way, so I understand!) – sometimes just a few small changes can make all the difference!