Tai chi could soothe your numbed limbs
Q I HAVE numbness and coldness in my feet, and my right hip and left shoulder feel heavy. I also get pins and needles in my left arm. A scan showed stenosis in my spine, but I’ve been told that alone isn’t the trouble. Is there any remedy? I’m 80, and otherwise in good health. Mrs Carina Young, Ruislip, Middlesex. A From your description, I cannot disagree with the diagnosis of lumbar spinal stenosis.
Stenosis is most commonly caused by degenerative arthritis, better known as osteoarthritis.
This wear and tear is often age‑related and leads to a narrowing of the central canal in the column which houses the spinal cord.
As a result, the spinal cord and nerves can become pinched, causing the numbness and cold‑ ness you mention, as well as pain and disability which gradually encroach on quality of life.
It is a very common problem, yet resolving it is not straightfor‑ ward — as you are finding. Physiotherapy is the mainstay of treatment, but evidence about the best procedures — from exercises to deep tissue massage or ultrasound treatments (to heat the surrounding muscles and ease pain) — is lacking.
There are no standard regi‑ mens, and different physios will use different methods, with var‑ ied results. The aim is to improve muscle stability and posture, as this will better support the spine and lessen the load on it.
Drug treatments include non‑ steroidal anti‑inflammatory drugs (NSAIDs) such as aspirin, and opiates to address the pain.
But there are concerns about some NSAIDs causing heart problems, and opiates should not be used long term. In your longer letter, you mention having had a ‘nerve and lumbar injection’, which gave you no relief. I would guess this was a corticosteroid jab, intended to relieve pain and swelling.
While there are some small studies suggesting these injections may reduce pain in the short term, I don’t think this is evidence enough.
In severe cases, spinal surgery to relieve nerve pressure by widening the narrowed spinal canal may be offered. But this is reserved for those with disabling pain, which doesn’t seem to apply in your case. Were you to have surgery, there is still little evidence that it would be of substantial benefit.
There are potential risks to consider, such as nerve damage, and the usual post‑operative risks of infection, deep vein thrombosis and more.
Given that you also describe some symptoms in your left shoulder, arm and hand, degen‑ erative changes in the cervical spine (the neck) might be devel‑ oping as well as the stenosis in the lower back or lumbar spine.
We do not have clear treatment options or guidelines for spinal stenosis, and the best I can sug‑ gest is that you seek out an experienced physiotherapist.
or you could consider a gentle form of yoga or tai chi which might, in time, reduce symptoms by aiding mobility and balance.
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