I had a patient ask me yesterday “I think I am getting carpal tunnel in my feet when I walk a couple of blocks or standing for a longtime. Do you know what this could be?”
I explained to him that he might have neurogenic (narrowing of the spinal canal in the lower spine) or vascular claudication. This is where the spinal cord or circulation gets pinched and cuts off the nerve supply to the feet giving a numbness or tingling feeling like carpal tunnel during walking or standing (other symptoms can include heaviness and weakness in the buttocks or lower leg). I continued that bending forward or sitting down for a couple of minutes will relieve the pain by opening up the spinal canal and stop the pinching on the spinal cord.
Some recent research has recently come out about exercise and treatment protocols that are listed below for neurogenic claudication.
1. Stretching the glutes (Piriformis, Gluteus Medius), quadraceps, groin muscles (adductors), and hip flexor muscles. (see below)
2. Nerve flossing (spinal cord and sciatic nerve) in a slumped position with leg straight and then reverse.
3. Lastly, treatment should focus on manual therapy aiming towards increasing flexibility of the low back in flexion.
Make sure to switch up exercises to give a variation and strengthen muscles back and lower body.
Some examples of stretches include 1. Laying on back knee to chest and knee to opposite chest stretches 2. Laying on your side heel to butt quadricep stretch 3. Kneeling hip flexor lunge stretch.
Exercise for controlling the low back may include: 1. Laying on your back pelvic tilts. 2. half sit ups 3. Laying on side straight leg raises, and clams (knee bent to 45 degrees). 4. Laying on stomach with leg extensions.
A graduated cycling program: using a stationary bike with a forward lean to improve lower extremity conditioning and overall fitness.
Remember take Pro-Action and be pro-active
Adductor Gluteal Medius Piriformis
Stretch Stretch Stretch
Quadracep Stretch Psoas Stretch
Study: Clinical Outcomes for Neurogenic Claudication Using a Multimodal Program for Lumbar Spinal Stenosis: A Retrospective Study
Author: Ammendolia C & Chow N
University of Toronto; Mount Sinai Hospital, Toronto; Canadian Memorial Chiropractic College, Toronto, Canada.
Publication: Journal of Manipulative & Physiological Therapeutics 2015; 38(3): 188-194.