What Is Spinal Stenosis?
The spine is made up of a series of connected bones, or vertebrae, and shock-absorbing discs. Its primary function is to protect the spinal cord, which rests in the canal formed by the vertebrae. Spinal stenosis is a condition in which the spinal column narrows and starts compressing the spinal cord. This process is typically gradual. If the narrowing is minimal, no symptoms will occur. Too much narrowing can compress the nerves which will cause problems.
What Causes Spinal Stenosis?
Some people are born with a small spinal canal. This is called “congenital stenosis”. However, the most common cause of spinal stenosis is aging. Degenerative processes occur throughout your body as it ages. Tissues in your spine may start to thicken and bones may get bigger, compressing the nerves. Conditions like osteoarthritis and rheumatoid arthritis may also contribute to spinal stenosis.
The risk of developing spinal stenosis increases if:
- You were born with a narrow spinal canal
- You are 50 years old or older
- You are female
- You have had a previous injury or surgery of the spine
Some medical conditions can cause spinal stenosis. These include:
- Osteoarthritis and bone spurs that form as we age
- Inflammatory spondyloarthritis (e.g., ankylosing spondylitis)
- Spinal tumors
- Paget’s Disease
What Are the Symptoms of Spinal Stenosis?
While not everyone has symptoms, those that do may experience back pain, stiffness and numbness. Symptoms of spinal stenosis often begin gradually and worsen over time. They may even vary depending on the location of the stenosis:
In the lower back (lumbar spine)
- Numbness, weakness or tingling in the foot or leg
- Pain or cramping in one or both legs when you stand for long periods of time
- Back pain
In the neck (cervical spine)
- Numbness, weakness or tingling in the arm, hand, foot or leg
- Problems with walking or balance
- Neck pain
- Urinary incontinence
How is Spinal Stenosis Diagnosed?
An orthopedic spine specialist will ask about your symptoms and medical history. If spinal stenosis is suspected, they will do a physical exam. Some symptoms they will look for include:
- Numbness, weakness, cramping or pain in the legs, thighs or feet that makes it hard to walk
- Pain that goes down the leg
- Abnormal bowel/and or bladder function
- Loss of sexual function
- In severe cases, partial or complete leg paralysis. This is considered a medical emergency and you should get to an emergency room as quickly as possible.
They will also consider other conditions that can cause similar symptoms, such as arthritis of the hips or knees, disorders of the nervous system or disorders of the heart and blood vessels. A spine specialist may also order other tests to confirm the diagnosis and determine the seriousness of your condition. These include:
- An X-ray of the spine to check for osteoarthritis, bone spurs and narrowing of the spinal canal
- A CT scan, which takes more detailed images of the back and spinal canal
- An MRI scan of the spine to take pictures of the spinal cord and nerves
- An EMG to check the nerves going to your legs
- X-rays of the hips or knees and blood tests, as well as tests to check the circulation in your legs and to rule out other diseases with similar symptoms
What Are the Treatment Options for Spinal Stenosis?
Spinal stenosis treatments depend on the severity of the injury. In most cases, your spine specialist will recommend nonsurgical options like:
- Medication: Aspirin, ibuprofen and pain remedies can offer short-term relief. Additionally, muscle relaxants can treat aspects of spinal stenosis including muscle spasms and damaged nerves.
- Corticosteroid injections: Your spine doctor will inject a steroid such as prednisone into your back or neck. While steroids reduce inflammation and pain, they are used sparingly because of the various side effects.
- Anesthetics: A nerve block, or neural blockade, is a minimally invasive procedure in which an injection of medicine can block the pain experienced from specific nerves.
- Exercise: Regular exercise can improve your balance, strength and flexibility. Your spine specialist may also recommend a physical therapist to assist you during recovery.
- Assistive devices: Braces, a corset or a walker can help you move about if you are experiencing pain in your neck or back.
- Surgery: If your symptoms do not improve with non-surgical treatments, your doctor may recommend minimally invasive spine surgery. The most common procedure is a laminectomy. This involves removing the bone spurs, ligaments and vertebrae that are pressing on the nerves.
When Should You See a Spine Specialist for Spinal Stenosis?
The bottom line is, the time to see a surgeon about surgery for spinal stenosis is when an individual is unhappy with his or her restricted activity level and has tried reasonable non-operative treatments (like anti-inflammatory medication, physiotherapy and epidural steroid injection).
You should contact your doctor if you are frequently experiencing numbness, tingling or pain in your arms, legs, feet or hands. If left untreated, spinal stenosis could lead to significant nerve damage and prevent you from carrying out regular activities.
Do not let spinal pain hold you back from living your life any longer! The orthopedic spine specialists at Ventura Orthopedics are leaders in their field and have been instrumental in advancing these techniques. We can answer any questions you may have regarding this procedure as an option for you.
To learn more about the procedure or to schedule an appointment with one of our spine specialists, call us at 800-698-1280.