Spinal Stenosis

What is spinal stenosis?

The backbone (spine) runs from your neck to your lower back. The bones of your spine form a spinal canal, which protects your spinal cord (nerves). Stenosis is a condition of narrowing the spinal canal or the foramen, the opening through where nerve roots pass. Stenosis can develop in any area of the spine.

Degenerative changes in the spine, a collapsed disc, bone spurs, or cysts can make the spinal channel thin. This narrowing puts pressure on the nerve roots as well as spinal cord, regularly resulting in pain.

The majority of people with spinal stenosis are over the age of 50. Although degenerative changes can develop spinal stenosis in younger people, typically additional causes need to be considered. These additional causes include congenital spinal deformities such as scoliosis, a genetic disease affecting bone and muscle development throughout the body or trauma. To determine the cause, spinal imaging is necessary.

Stenosis Symptoms

Cervical Stenosis:

• Stiffness in neck
• Pain and Numbness in hands and/or arms
• Weakness in arms causing difficulty using the hands

Lumbar Stenosis:

• Cramping sensation in these areas
• Tired, heavy feeling in back, buttocks, and legs while walking or standing
• Decreased walking due to weakness, numbness or pain in legs

Stenosis Causes

Cervical Stenosis:

• Bone spurs push on nerves and spinal cord
• Arthritic changes in neck
• Compression can be caused by large disc herniations

Lumbar Stenosis:

• Degenerative changes limit nerve space; lack of blood supply induces symptoms

Spinal Stenosis Treatment

Typically when treating spinal stenosis your physician may advise you to take over the counter medication, such as naproxen (Aleve) or Ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) to temporarily ease any discomfort. Your doctor may then prescribe medications such as antidepressants, which are sometimes prescribed as a nightly dose to help relieve chronic pain. Another medication your physician might prescribe is anti-seizure drugs are used to reduce pain caused by damaged nerves. Opioids are sometimes used short term for pain relief. Although, they carry a high risk of serious side effects.  If medications are not offering pain relief, your doctor may next prescribe physical therapy.

Non-Surgical Spinal Stenosis Treatments:

Physical therapy is very common when treating spinal stenosis, due to the fact that patients tend to become inactive in an effort to relieve the pain. While this is common, it can often lead to muscle weakness, which in turn can result in more pain. A physical therapist is important at this step to teach you exercises that can help:

• Maintain the flexibility and stability of your spine
• Build up your strength and endurance
• Improve your balance

Once you have completed physical therapy your doctor may suggest a steroid injection (cortisone injections.) While injections are not for everyone, it can relieve a lot of pain in some patients.

Surgical Spinal Stenosis Treatments:

If conservative treatments don’t offer relief. Your physician may recommend surgery. To include the following:

Cervical Laminectomy Laminectomy (a Spinal Decompression) is a surgical procedure that removes the back wall of the spinal canal, called lamina, to create more space for the spinal cord, thus relieving pressure on the spinal cord and/or spinal nerves.

Lumbar Decompression: This procedure involves removing all or portions of the lamina, bone spurs and/or enlarging foramen to relieve pressure or compression on the nerve roots or spinal cord. This pressure often is the cause of the pain.

Spinal Fusion: Spinal fusion is a surgical procedure that helps to relieve pain in the vertebrae (spinal bones) by fusing two or more vertebrae together to reduce motion.   This procedure is done through a bone graft or a metal implant.