training with severe spinal stenosis (cervical)

I’d love to hear advice or anyones experience with training with cervical radiculopathy.
About 6 years ago an MRI showed severe spinal stenosis (C6- C7 foraminal). I’ve had a few occurrences over the years of severe pain and radiculopathy, but recently had my first experience with it since I started barbell training. Prednisone helped immensely with the initial pain, but the numbness and tingling remains. After 2 weeks off, and being mostly pain free, I tried to start training again with about a 20% reduction in weight and a decrease in volume. Substantial pain returned within 1 day of training, and got worse after the second day of training.
I’m not sure if I should be continuing to train, or if more time off will allow the inflammation of the nerve root to go down.

Hey daveo, stenosis is your radiographic finding, cervical radiculopathy is the symptoms. Imaging findings of stenosis do not mean that you cannot train. How long ago did this most recent exacerbation occur? It often comes down to training within your symptoms, which at times means going light. Typical resolution for radiculopathy is 3-4 months so if it has only been 2 weeks you are well within the normal window of symptoms.

Thanks Derek, I appreciate the response. It’s been about a month now since the last onset. What ballpark would be considered “going light”? Beforehand I was squatting 275x5, Dead 305x5, Bench 205x5. When I tried to train last I squatted 225, pulled 245, and benched 165, and it certainly aggravated the symptoms. I’m uncertain if I should be taking a little bit more off? or a drastic reduction? 5-10lb jumps in a NLP fashion moving forward? OR hold off on increases until radiculopathy symptoms are gone?

The answer for “going light” is based off what you can tolerate. Sometimes, when you’re having an exacerbation, the answer for light enough is an empty bar. Percentage wise your last session was 81%, 80%, 80% of your prior numbers. If I were to ask you what percentage you would perceive yourself at right now, with current symptoms, would you say 80%? The answer to that question may be a good way of framing where you are at.

Thanks Again Derek. This has been very helpful. One last question if I may. If lifting does not exacerbate the pain symptoms, but it does trigger the tingling that runs down the arm, is that something to worry about or address? I have dropped additional weight from the bar across the board, and have been mostly pain free (with tingling down the arm through out the day). But deadlifting triggers the tingling, multiplying it greatly—again, with no pain.

daveo

Are your symptoms consistently produced the exact same way every time? It sounds like you have good days and bad days. If you have good and bad days stenosis is not the correct diagnosis. The neural foramen don’t just open up on your good days and close on your bad days.

If I misunderstood, please correct me.

hi floydd
Do you mean you don’t think my stenosis is causing the pain and the radiculopathy? From what I thought I understood, the stenosis made the nerve more susceptible to irritation and compression.
I think it’s been more than 2 years since I last had any issues before this current onset. So it’s less good days and bad day then it is good years, and then a bad 6 weeks. Over the course of 6-7 years there have been 4 “episodes”. They start with a dull ache in the neck and shoulder, and quickly escalates to pretty severe pain, numbness and tingling. Then it’s all bad days (no good days) for about 7-10 days until the prednisone cycle is finished. After that the pain is more manageable but consistent. After 5 weeks there is very little pain but the tingling and numbness increases when I lift, and especially when I deadlift.

Correct I don’t think the stenosis is the cause of your pain. If stenosis was the cause of your pain whenever you do the aggravating activity that caused your pain to occur the first time will put you in pain the next time you do that same thing. You would not have years of no pain between episodes unless during those pain free times you have avoided the previously aggravating activities completely (or else you would have had a flare up). However it does not really matter what is the cause and there is nobody that can tell you with certainty what exactly is the cause. What matters is how you are going to overcome your pain.

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