The human body is full of incredible capabilities and your spine is just one of them. Spine health is important because without a healthy spine, your mobility is limited, and you may have difficulty sitting up straight, walking, twisting, bending over, or moving your neck.
Spinal stenosis is a disorder affecting the spine causing nerve compression and low back pain. Learn more about spinal stenosis including how it can be treated by medical professionals.
What Is Spinal Stenosis?
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Spinal stenosis is the narrowing of open spaces within your spinal canal putting pressure on your spinal cord. This can also affect the nerves traveling through your spine which can cause pain in your arms and legs.
This condition is most common in the lower back and neck and often occurs in patients age 50 and older. However, degeneration is not always the cause. Patients can be born with spinal stenosis or it can result from an accident.
What Are Spinal Stenosis Symptoms?
Patients diagnosed with spinal stenosis often experience low back pain and pain in their legs. Nerves which control muscle power and sensation in the legs may be pinched causing the following symptoms:
- Pain in low back and legs or difficulty walking
- Tingling, numbness, and hot or cold feeling in the legs
- Clumsiness or frequent falling
- Issues with normal bladder or bowel function
Spinal stenosis symptoms develop slowly over time and often come and go as opposed to continuous pain. Symptoms may occur during activities such as walking or biking and are relieved by sitting or lying down.
Who’s at Risk for Spinal Stenosis?
Spinal stenosis is common in men and women over age 50. However, a narrowing of the spinal column can be apparent at birth or caused by an accident or injury. The following is an overview of the risk factors.
As you age, your body’s ligaments (connective tissue between the bones and spine) thicken and spurs or small growths may develop on bones in the spinal canal. Discs between the vertebrae deteriorate and the flat surfaces on each vertebra break down. A combination of these factors can result in a narrowing of the spaces in the spine.
Rheumatoid and osteoarthritis are two disorders that affect spine health.
If you’re born with a small spinal canal, spinal stenosis symptoms may begin as a child. Structural deformities of the vertebrae can cause a narrowing of the spinal canal.
Accidents or injuries of the spine and spinal canal can cause dislocation or burst fractures where bone fragments penetrate the canal.
Instability of the spine
The spinal canal can be narrowed when one vertebra slips forward on another.
Abnormal growths of soft tissue can cause inflammation in the spinal canal, bone loss, or displacement of bone. This can result in a collapse of the supporting framework in the spinal column.
How Is Spinal Stenosis Diagnosed?
Spinal stenosis can be diagnosed by your doctor. They’ll ask questions about your medical history (injuries, conditions, general health problems, etc.), conduct a physical examination, and schedule diagnostic imaging.
Imaging can include either an MRI scan, a CT scan, or both.
CT scans show the causes of spinal stenosis in the bones, but can’t offer the fine details on soft tissue diseases, including ligament hypertrophy, disc herniations, or disc bulges.
MRIs measure the canal dimensions and dynamic changes of the spine. They can detect damage or disease in soft tissue in discs between vertebrae or ligaments.
Radiology technology is constantly evolving and changing often making additional information available by these tests.
Who Treats Spinal Stenosis?
Your doctor will provide you with recommendations for the treatment that’s best for you. Nonsurgical treatment is often provided by physical therapists, general practitioners, or specialists.
Rheumatologists, who treat arthritis and related disorders, and neurologists, who treat nerve diseases, often help patients struggling with spinal stenosis. Neurosurgeons and orthopedic surgeons can perform spinal surgery if needed.
What Nonsurgical Treatments Are Available?
Nonsurgical treatments for spinal stenosis include:
- Exercise – Physical therapy programs and exercise are often a component of spinal stenosis treatment. Inactivity causes greater debilitation, so it’s important patients stay active.
- Modified activities – Some activities may worsen spinal stenosis symptoms. Doctors may recommend activity modifications such as walking bent over rather than upright or sitting in a recliner instead of a straight-back chair.
- Cortisone injections – When injected into the epidural space, cortisone can offer temporary relief of symptoms.
- Medications – Aspirin or ibuprofen are anti-inflammatory medications which may relieve painful symptoms due to inflammation. Short term use of narcotic medications may help with nerve related pain symptoms. Muscle relaxers and nerve desensitizing medications may also be prescribed.
- Chiropractic care – Chiropractors may adjust the spine to create normal spine movement. Their adjustments may increase space between the vertebrae and reduce pressure on the nerves.
- Acupuncture – This treatment stimulates areas on the skin by inserting thin, metallic needles into the skin. Acupuncture is known to help with low back pain in some patients.
When Should Surgery Be Considered and What Does It Involve?
In many cases, nonsurgical treatments offer relief, but they do not permanently alter the condition. A doctor may recommend nonsurgical treatments first to see how they help.
Surgery may be considered right away if you’re experiencing weakness or numbness associated with walking, neurological impairment, or reduced bladder or bowel function.
Surgery can relieve pressure on the spinal cord or nerves and restore strength and alignment of the spine. Surgeons may remove, trim, or adjust diseased parts causing pressure on the spine.
What Long Term Outcomes Are Expected from Surgery?
When an obstruction causing the symptoms is removed, most people experience relief with less leg pain and the ability to walk.This relief is often greater than relief experienced by nonsurgical treatments alone.
If nerves are badly damaged before surgery, patients may continue to experience pain and numbness. In some cases, patients experience no improvement. The degenerative process may continue following surgery creating pain or limitation of mobility later.
If you’re experiencing symptoms of spinal stenosis, consult with your doctor for a diagnosis and treatment plan. Advancements in medical technology and treatment options can help offer the relief you need.