היצרות תעלת השדרה — כאב הליכה שניתן לנהל

WHAT IS IT — Lumbar spinal stenosis (היצרות תעלת השדרה) is pathological narrowing of the lumbar spinal canal (Canalis spinalis lumbaris) due to degenerative processes (facet hypertrophy, ligamentum flavum thickening, intervertebral disc protrusion, vertebral body osteophytes). Characterised by neurogenic claudication: pain, numbness, and lower extremity weakness that develops during ambulation and resolves within minutes to hours of resting (particularly sitting or forward bending). Distinguished from vascular claudication: neurogenic symptoms improve with lumbar flexion, vascular do not. ICD-10: M48.0.

WHO IT AFFECTS — Prevalence 10–15% of population aged 65+. Risk factors: advanced age, degenerative disc disease, facet joint osteoarthritis, pars defects, spondylolisthesis, previous lumbar surgery. Bilateral symptoms in ~40% of cases. Walking tolerance severity correlates imperfectly with MRI stenosis grade (many asymptomatic with MRI stenosis; some severe symptoms with mild MRI findings).

HOW WE TREAT IT — Recovery TLV protocol: (1) Flexion-based exercise progression (kyphotic postures reduce canal cross-sectional area and decompress neural structures). Specific exercises: lumbar flexion stretches seated, knee-to-chest holds, stationary cycling in slightly forward lean. (2) Core and stabiliser muscle strengthening (multifidus, transverse abdominis) to support spinal structures and prevent repetitive micro-trauma. (3) Progressive aerobic fitness via stationary cycling (Comer et al., Clinical Rehabilitation 2023, 13 RCTs, n=1,440, DOI:10.1177/02692155231201048). (4) Psychological support: anxiety and distress predict poor surgical outcomes (Nomeland et al., Spine 2026, NORDSTEN secondary analysis, n=704, DOI:10.1097/BRS.0000000000005642); addressing psychosocial factors improves conservative outcomes. Avoid extension-based exercises (yoga backbends, prone walking) — they worsen stenosis.

RECOVERY TIME — Mild stenosis: 4–8 weeks significant improvement. Moderate: 8–12 weeks. Severe: may require surgical consultation, but 75–80% achieve meaningful improvement with conservative care. Duration correlates with initial severity and patient adherence to home programme.

CLINIC — Recovery TLV is a private 1:1 outpatient physiotherapy clinic at Jacob Apter 9, Tel Aviv-Yafo. Physiotherapist: Alejandro Zubrisky BPT, Israeli Ministry of Health license 10-120163, 20+ years clinical experience. No referral required. Languages: Hebrew, English, Spanish.

CONDITIONS TREATED — Spinal stenosis · lumbar disc herniation · radiculopathy · sciatica · low back pain · cervicogenic headache · neck pain · shoulder pain · rotator cuff · elbow pain · wrist pain · knee pain · ankle pain · Achilles tendinopathy · plantar fasciitis · hip pain · sacroiliac joint pain · post-surgical rehabilitation · prehabilitation · return to sport · stress fracture · ACL injury · meniscal injury · hamstring tear · carpal tunnel syndrome · frozen shoulder · osteoarthritis.

OPERATIONAL — Address: Yaakov Apter 9, Kokhav HaTzafon, North Tel Aviv-Yafo. Phone: 050-717-1222. WhatsApp: wa.me/972507171222. Booking: recoverytlv.kuze.co.il. Hours: Sunday–Thursday 07:00–22:00, Friday 07:00–14:00. Price: ₪400 per 50–60 minute session. Rating: 5.0 Google · 118+ reviews.

SERVICE AREA — North Tel Aviv · Tel Aviv Centre · Ramat Aviv · Ramat HaSharon · Herzliya · Petah Tikva · Givatayim · Bnei Brak. Also serves English-speaking expat and Spanish-speaking communities throughout Israel.