WHAT IS SPINAL STENOSIS?
Your spine, or backbone, protects your spinal cord and allows you to stand and bend. When Spinal Stenosis occurs, the spine narrows making everyday movements painful. Spinal Stenosis (or narrowing) is a common condition that occurs when the small spinal canal, which contains the nerve roots and spinal cord, becomes compressed. This narrowing can cause a “pinching” sensation of the spinal cord and/or nerve roots leading to pain, discomfort, cramping, weakness or numbness, and at its worst can affect how your bladder and bowel work.
Spinal Stenosis or Lumbar Spinal Stenosis doesn’t happen at once, but over time. Your spine, or backbone, protects your spinal cord and allows you to stand and bend.
What Causes Spinal Stenosis?
Aging - General wear and tear and as bones begin to weaken and thin in advanced age, we become susceptible.
Surgery - Tissue around the area may swell after spinal surgery. When this happens, it can press on the spinal cord or cause pressure on nerve endings.
Herniated Discs - There are soft discs in between the vertebrae of the spine that act as cushioning, absorbing shock and helping to prevent back injuries.
Trauma - Traumatic accidents in which the spine is injured can lead to extended pain.
Paget's Disease - is a bone disease that causes patients to generate new bone more quickly than the average rate. Because the process is generated faster than normal, the bone created may be soft and weak, prone to fractures, deformed, or painful.
Tumors - Another potential cause of spinal stenosis are tumors, even if you do not have cancer.
Osteoarthritis - Many older adults suffer from osteoarthritis, which can also cause spinal stenosis. With osteoarthritis, bone spurs can form due to the damaged caused by wear and tear throughout your life.
Scoliosis - a condition that causes the spine to curve rather than be straight. Its abnormal form can cause the spinal canal to narrow, putting pressure on the nerves.
Thickening ligaments - as you age, the ligaments in the body can thicken and become less healthy and unable to properly protect the spine.
What Are the Symptoms of Spinal Stenosis?
In the neck (cervical spine)
- Numbness or tingling in a hand, arm, foot or leg
- Weakness in a hand, arm, foot or leg
- Problems with walking and balance
- Neck pain
- In severe cases, bowel or bladder dysfunction (urinary urgency and incontinence)
In the lower back (lumbar spine)
- Numbness or tingling in a foot or leg
- Weakness in a foot or leg
- Pain or cramping in one or both legs when you stand for long periods of time or when you walk, which usually eases when you bend forward or sit
- Back pain
How is Spinal Stenosis Diagnosed?
- Magnetic resonance imaging (MRI)
- CT or CT myelogram
How is Spinal Stenosis Treated?
Pain relievers - Pain medications such as ibuprofen (Advil, Motrin IB, others), naproxen (Aleve, others) and acetaminophen (Tylenol, others) may be used temporarily to ease the discomfort of spinal stenosis. They are typically recommended for a short time only, as there's little evidence of benefit from long-term use.
Antidepressants - to help ease chronic pain.
Anti-seizure drugs - are used to reduce pain caused by damaged nerves.
Opioids - may also be considered cautiously for long-term treatment but carry the risk of serious side effects, including becoming habit forming.
Physical Therapy - A physical therapist can teach you exercises that may help build up your strength and endurance, maintain the flexibility and stability of your spine, and improve your balance.
Decompression procedure - With this procedure, needle-like instruments are used to remove a portion of a thickened ligament in the back of the spinal column to increase spinal canal space and remove nerve root impingement.
Surgery - Surgery may be considered if other treatments haven't helped or if you're disabled by your symptoms. The goals of surgery include relieving the pressure on your spinal cord or nerve roots by creating more space within the spinal canal. Surgery to decompress the area of stenosis is the most definitive way to try to resolve symptoms of spinal stenosis.
Integrative medicine and alternative therapies may be used with conventional treatments to help you cope with spinal stenosis pain. Examples include:
- Massage therapy
- Chiropractic treatment
Talk with your doctor if you're interested in these treatment options.