What is spinal stenosis?
Spinal stenosis is a restriction of the open passageways where the spinal cord and spinal nerves travel down the back. This restriction occurs by a gradual narrowing of the opening, or the intrusion of something into the opening. Either condition can compress the nerves, causing neck pain if occurs in the cervical (neck) region of the spine, and low back pain and sometimes leg pain if it occurs in the lumbar (lower back) region. About 75% of spinal stenosis cases occur in the lower back.
What causes spinal stenosis?
Spinal stenosis can be caused by a myriad of conditions, including:
• Aging — Bone spurs, vertebral disk degeneration, facet joint weakening/failure and thickening ligaments can all cause a narrowing of the spinal canal.
• Arthritis — Rheumatoid arthritis and osteoarthritis — which can cause excess bone growth around spinal nerves — are both common causes of spinal stenosis.
• Spondylolisthesis — One vertebra slipping forward over another can narrow spinal spaces.
• Genetics — A person is born with a small spinal canal or vertebral deformity is more susceptible to spinal stenosis.
• Tumors — Any soft tissue growth in the spine, including tumors, can directly press on spinal nerves. Tumors can lead to bone loss and/or displacement, which can narrow spinal canal and also lead to the collapse of the spinal column.
• Trauma — Serious injury can dislocate the spine, or cause “burst fractures,” where bone fragments penetrate the open spaces in the spinal column.
What are some symptoms of spinal stenosis?
Symptoms of spinal stenosis vary depending on location and severity, and often start gradually and build over time. Common symptoms include:
• Back pain, leg pain
• Weakness in the neck, back, arms or legs
• Numbness, loss of sensation, tingling, feelings of hot or cold in the limbs
• Sciatica, or burning pain through the buttocks and legs
• Bladder/bowel control issues
• Clumsiness, lack of coordination, difficulty walking, frequent falling
What are some risk factors of spinal stenosis?
The biggest risk factor for spinal stenosis is age, with most patients experiencing their first symptoms in their 50s. Most spinal stenosis in patients under 50 is caused by a genetic condition.
Like age and genetics, arthritis, heart disease and diabetes are other factors that are difficult to control. Weight gain, repetitive motions, muscle/core weakness, engaging in activities that are more likely to produce a spinal injury, smoking and poor are examples of factors that can be controlled.
What treatments are available for spinal stenosis?
There are many different treatment options for spinal stenosis. Most individually crafted treatment plans will include some of the following:
• Changes in posture — Several simple adjustments can provide relief, such as leaning forward while walking and lying with the knees drawn up to the chest, by enlarging the spinal canal
• Rest — Taking as much work off your spine as possible, then slowly resuming activities
• Physical therapy — A routine designed by a specialist to strengthen surrounding muscles and alleviate symptoms
• Exercise — Regular, controlled exercise, like cycling, can build and maintain strength in the arms, upper legs, hips and back, which will improve balance, walking, flexibility and pain
• Medication — Non-steroidal anti-inflammatories like aspirin or ibuprofen can reduce the swelling that is pressing on spinal nerves; acetaminophen and naproxen can relieve pain
• Steroid/cortison injections — Relieve pain and swelling at the source
• Surgery — If all else fails, surgery may be the only way to create more space for the affected nerves