Spinal stenosis is a common condition that occurs when the spinal canal, which contains the nerve roots and spinal cord, becomes compressed. This causes a “pinching” of the spinal cord and/or nerve roots, which leads to pain, cramping, weakness, or numbness.
Depending on where the narrowing takes place in the spine, the symptoms may appear in the lower back and legs, neck, shoulder, or arms. There is no cure for spinal stenosis, but there are specific pain management techniques that can help reduce the pain and improve flexibility (the ability to bend and move about).
What is Spinal Stenosis?
As we age, our spine changes. Degenerative changes of the spine are found in up to 95% of people by the age of 50. The normal wear-and-tear effects of aging lead to a narrowing of the spinal canal, a condition we call spinal stenosis. Age-related narrowing of the spinal column is generally due to arthritis and leads to bony overgrowths of the vertebrae (individual bones of the spine).
Adults over 60 years old are most likely to develop spinal stenosis. However, there are a small number of people born with back problems that develop into spinal stenosis, which is known as congenital spinal stenosis. It occurs most often in men with symptoms first appearing between the ages of 30 and 50.
Stenosis is from a Greek word (stenos) meaning ‘narrow.’ In modern medical terms, stenosis is an abnormal narrowing of a passage in the body. Spinal stenosis can cause a narrowing of one or more areas of the spine:
The space at the center of the spine which surrounds the spinal cord.
The areas where nerves branch out from the spine to other areas of the body.
The space between the vertebrae.
This narrowing occurs most often in the lower back or neck and worsens over time. Typically, a person with this condition complains of severe pain in the legs, calves, or lower back when standing or walking. The pain may come on more quickly when walking up or down a hill, a ramp, or steps. Sitting down or leaning forward usually helps relieve the pain.
Some people with spinal stenosis may not experience any symptoms. Others may have pain, tingling, numbness, and muscle weakness. Because of this, the term “spinal stenosis” actually refers to the symptoms of pain and not to the narrowing itself.
The types of spinal stenosis are classified according to where (on the spine) the condition occurs. The two main types of spinal stenosis are:
Cervical stenosis. In this condition, the narrowing occurs in the part of the spine that is in the area of the neck.
Lumbar stenosis. In this condition, the narrowing occurs in the part of the spine that is in the area of the lower back, which is the most common form of spinal stenosis.
Symptoms of Spinal Stenosis
The most common symptoms of spinal stenosis are:
Problems with walking and balance.
Cramping in the calves when walking, requiring frequent short rests to walk a distance.
Lower back pain while standing or walking.
Numbness or tingling in a hand, arm, foot, or leg.
Weakness, cramping, or pain in an arm or leg.
Pain in the neck, back, or going down the 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 bending forward or sitting.
Pain radiating into one or both thighs and legs, similar to
A pain that feels like an ache or a burning that typically starts in the area of the buttocks and radiates down the leg. As the disease progresses, it can result in foot pain.
Weakness in the legs or “foot drop,” the feeling that the foot slaps on the ground while walking.
Less pain with leaning forward or sitting. Studies of the lumbar spine show that leaning forward can actually increase the space available for the nerves. Many patients may note relief when leaning forward and especially with sitting. Pain is usually made worse by standing up straight and walking.
Some people may experience a severe type of spinal stenosis called cauda equine syndrome. This condition causes the loss of bowel or bladder control, in addition to the other symptoms.
Rarely, untreated severe spinal stenosis may progress and cause permanent:
Causes of Spinal Stenosis
As the body ages, degenerative processes occur. In the spine, tissues begin to thicken, and the bones may grow larger. Spinal narrowing that is the result of age-related changes and takes place over time is called “acquired spinal stenosis.” However, some people are born with “congenital stenosis” (a small spinal canal).
The principal reason for spinal stenosis is arthritis, which causes the breakdown of the cushiony material between the bones (cartilage) and the growth of bone tissue. Osteoarthritis can lead to disc changes, thickening of the ligaments of the spine, and bone spurs.
All of these conditions can place pressure on the spinal cord and cause pain. Other conditions that can cause spinal stenosis include:
Besides regular doctor’s follow-up appointments to monitor the condition. You can incorporate several home treatments to help with pain management. These include:
OTC pain relievers. Over-the-counter medications such as aspirin, ibuprofen, naproxen, and acetaminophen can help reduce inflammation and pain.
Applying hot or cold packs. Some symptoms of cervical (neck) spinal stenosis may be relieved by applying heat or ice to your neck. Cold helps to restrict blood vessels, reduce fluid in the tissues, and decreases swelling and pain. Heat opens the blood vessels and increases circulation, bringing nutrients and proteins essential for repairing damaged tissue. Heat is also useful to help relieve stiffness.
Maintaining a healthy weight. Aim to keep a healthy weight. Losing excess weight can reduce pain by taking stress off the back, particularly the lumbar (lower) portion of the spine.
Exercising. Flexing, stretching, and strengthening exercises can help open up the spine. Moderation is the key. A 30-minute walk every other day may be all you need. Make sure your doctor or a physical therapist approve the best and safest exercises for you.
Using a cane or walker. In addition to providing stability, these assistive devices can help relieve pain by allowing you to bend forward while walking.
Practicing good posture. Stand up straight, sit on a supportive chair, and sleep on a firm mattress. Lift heavy objects by bending from the knees, not the back.
Minimally Invasive Procedures
In some cases, the pain management of spinal stenosis is accomplished with a minimally invasive procedure to restore function and regain an active lifestyle. These include:
Percutaneous adhesiolysis. The procedure, also known as the Racz procedure, is proven effective in removing excessive scar tissue in the epidural space. Scar tissue originates from inflammation, irritation, and surgery.
Spinal cord stimulation (SCS).Spinal cord stimulation in often effective in treating spinal stenosis. SCS involves implanting an electrical device that decreases the perception of pain by producing tingling electrical signals that replace the pain signals.
Nerve block. The injection of an anesthetic near damaged nerves to turn off the pain signals.
The Novus Spine & Pain Center is in Lakeland, Florida, and specializes in treating the chronic pain caused by spinal stenosis. By using a comprehensive approach and cutting-edge therapies, we work together with patients to restore function and regain an active lifestyle, while minimizing the need for opiates.
Our Mission Statement:To provide the best quality of life to people suffering from pain, by providing state of the art treatments, knowledge and skill, compassion, and respect for all.