Spinal stenosis is a condition that causes the spinal canal, or other vertebrae openings, to narrow and compress the spinal cord or other nerves. Compressing a nerve causes inflammation and pain, which often occurs in the neck or lower back. Furthermore, severe spinal stenosis can cause permanent nerve damage.
Often, patients diagnosed with spinal stenosis are told surgery is the only pain relief option. However, it is possible to avoid major surgery with minimally invasive procedures that can help reduce or even relieve the pain.
For most people, the stenosis occurs because of arthritis, which is often the result of aging and “wear and tear” on the spine from daily activities. Some patients, however, are genetically more prone to stenosis, or diseases that lead to it. In these cases, the condition can cause problems in people as young as 30. For most people, though, spinal stenosis usually appears after the age of 50.
The pinching of the spinal cord, or the nerves around it, causes pain, tingling, or numbness in the legs and arms. In advanced cases, it may cause weakness. There’s no cure, but there are a variety of non-surgical treatments and exercises to keep the pain at bay, which help most people with spinal stenosis live normal lives.
Causes and Symptoms of Spinal Stenosis
“Stenosis” comes from the Greek word meaning “narrowing.” The primary cause of spinal stenosis is arthritis, a condition that breaks down bone cartilage. Osteoarthritis can cause a change in the discs of the spine, a thickening of the ligaments of the spine, and bone spurs. All of this can place extra pressure on the spinal cord and spinal nerves.
Other causes of spinal stenosis can include:
Herniated discs. If the discs that cushion the vertebrae become cracked, the material inside can seep out and press on the spinal cord or nerves.
Injuries. An accident can fracture or inflame a portion of the spine.
Osteophytes. Bones and joints enlarge as a result of the degeneration of joint cartilage, and bone spurs can form.
Paget’s disease. A condition that affects bone growth. This disease causes bones to be brittle, abnormally large and misshapen, and can result in a narrowing of the spinal canal.
Spondylolisthesis. The slipping of one vertebra onto another, usually in the base of the spine, that leads to compression.
Tumors. A cancerous growth can touch, or pinch, the spinal cord.
When these conditions occur in the spinal area, causing the spinal canal to narrow, they can create pressure on the spinal nerves.
The most common symptom of spinal stenosis is pain and numbness, or tingling, in legs that is more pronounced when standing or walking. Relief is typically obtained by bending forward or sitting. Because we tend to bend over slightly when walking uphill, the symptoms of spinal stenosis may be less when going uphill and worse going down.
Treatments for Spinal Stenosis
There are many non-surgical and minimally invasive treatment options for spinal stenosis available at Novus Spine & Pain Center for spinal stenosis. The treatment depends on the location of the stenosis and the severity of the signs and symptoms.
If the symptoms are mild, treatment may be monitoring the condition with regular follow-up appointments and home self-care tips. If these don’t help, medications or physical therapy may be necessary. Minimally invasive treatments and surgical options are available when other treatments fail to help relieve the pain.
Some pain management can be accomplished at home to help ease the symptoms of spinal stenosis. Home care pain management activities include:
Apply heat and cold. Heat helps loosens muscles, cold helps heal inflammation. Hot showers can also be helpful.
Exercise that is moderate and not strenuous. Sometimes just a 30-minute walk every other day can be beneficial. Be sure to consult your doctor before starting any new exercise plan.
Lose weight. The more weight one carries, the more pressure is placed on the back.
Practice good posture. Stand up straight, sit on a supportive chair, and sleep on a firm mattress. Lift heavy objects bending from the knees, not the back.
Your doctor may prescribe:
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, since there’s little evidence of benefit from long-term use.
Anesthetics. Used with precision, an injection of a “nerve block” can stop the pain for a time.
Antidepressants. Nightly doses of tricyclic antidepressants, such as amitriptyline, can help ease chronic pain.
Anti-seizure drugs. Some anti-seizure drugs, such as gabapentin (Neurontin) and pregabalin (Lyrica), can help reduce the pain caused by damaged nerves.
Steroid injections. The injection of steroid medication (corticosteroid) into the space around pinched nerves can help reduce the inflammation and relieve some pain. When severe, an epidural steroid injection places a powerful anti-inflammatory medication near the affected nerves to reduce pain. However, the treatment does not fix the stenosis. Injections are limited to a few times a year, because repeated use can weaken nearby bones and connective tissue.
It’s common for people who have spinal stenosis to become less active, in an effort to reduce pain. But inactivity leads to muscle weakness and results in more pain. Engaging in exercise and physical therapy that focuses on strengthening the back and abdominal muscles, as well as stretching, can be beneficial.
A physical therapist may recommend assistive devices – braces, a corset, or a walker – that can be helpful in making movement less painful.
Additionally, physical therapy can:
Build up strength and endurance.
Maintain the flexibility and stability of the spine.
In some cases, rest or limited activity, depending on the extent of the pain and nerves involved, can be beneficial before beginning an exercise program.
Minimally Invasive Procedures
A minimally invasive medical procedure is one that is carried out by entering the body through the smallest possible opening in the skin, with the least damage possible. Some of these procedures include:
Epidural steroid injections. This procedure involves injecting a medication into the epidural space, where irritated nerve roots are located. This injection includes both a long-lasting steroid and a local anesthetic.
Percutaneous adhesiolysis.Adhesiolysis performed through the skin (percutaneous) – also known as the Racz procedure – is an effective method of removing excessive scar tissue in the epidural space that originates from inflammation, irritation, and often after surgery.
Spinal cord stimulation (SCS).Spinal cord stimulation is often effective in treating spinal stenosis. SCS involves implanting an electrical device that decreases the perception of pain by confusing the spinal cord and brain pain processing centers. Tingling electrical signals replace the pain signals.
Injections of a “nerve block” can stop the pain for a time.
Integrative medicine and alternative therapies, in conjunction with conventional treatments, can help you cope with spinal stenosis pain. Examples include:
Most patients with spinal stenosis respond well to non-surgical treatments and do not require surgery. However, if non-surgical treatment options do not ease the pain and help the patient to engage in everyday activities, surgery may be necessary.
Novus Spine & Pain Center
Dr. Torres established Novus Spine & Pain Center in Lakeland, Florida with a goal of providing the highest quality pain management care to every patient. Whether pain is the result of an injury or from another condition, Dr. Torres offers many different treatment options.
Novus Spine & Pain Center utilizes a comprehensive approach and cutting-edge therapies to restore normal function and allow patients to regain an active lifestyle while minimizing the need for opiates. As our patient, you are our top priority. Our goal is to help you achieve the best possible quality of life.
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.