Spinal stenosis of the neck and low back can be a source of much pain and disability for many people, and a lot of confusion exists with the condition.
Spinal stenosis is simply any narrowing of the open spaces of your spinal segments, which can put undue pressure on the spinal cord and nerves that travel through the spine to your arms and legs.
The majority of our population that suffers from spinal stenosis are in their 50’s and above because the long degenerative (arthritic) changes take many years to cause the narrowing of the spaces in your spine.
The causes of stenosis are due to overgrowth of bone, herniated disks, and thickened ligaments of the spine, tumors, and spinal injuries. An interesting fact about the older age population is they don’t suffer from herniated disks like the below 50 Yrs of age population since the degeneration of the spine has caused a dehydration of the disks and doesn’t allow for as much of a chance for herniation.
This critical distinction is key in making sure to prescribe the right types of corrective exercises and lifestyle modifications that we will discuss further.
If the younger population suffers from stenosis, it is most likely the cause of a genetic disease affecting bone and muscle development throughout the body.
Symptoms Of Stenosis
The typical symptoms of stenosis are numbness, weakness, tingling, pain, and cramping in the arms or legs. Typically you will see the pain and cramp symptoms more in the legs than arms due to long periods of standing. These symptoms usually will vary and gradually worsen over time. They will have periods of no symptoms and periods of worsened symptoms.
Spinal stenosis can be a tough diagnosis to conclude because the signs and symptoms mimic those of many aging population conditions. A detailed history and consultation is the first key when investigating the cause of the person’s symptoms. Imaging studies may be required to pinpoint the exact cause of the symptoms. X-ray imaging may be a good initial start, but the MRI is the gold standard for diagnosing the intricate details of spinal stenosis.
The conservative management of the symptoms is the best start for treating spinal stenosis.
Reversing the degenerative changes associated with most cases of spinal stenosis is not possible in conservative management. However, a reduction of symptoms and improvement in activities of daily living occur often for those suffering from this condition. The combination of mechanical lumbar or cervical traction, specific corrective exercises, and some muscle therapy.
Another instrumental aspect of management is lifestyle modification such as avoiding the lumbar or cervical extension (arching) of the spine. If you can maintain a neutral spine or slight flexion during sitting, standing, and movement, this will keep the spinal spaces open more and allow for a little more clearance for the nerves. This is a highly important aspect of spinal stenosis management.
What Are The Options?
If conservative therapy doesn’t get the desired results, there are more advanced treatments that are options depending on the severity of your symptoms. Steroid injections are an option, but they do not work for everyone, and you can only attempt a few of those due to the bony and ligament weakening.
The last resort would be to have spinal surgery to remove some of the bone growth formation and clear more space in the holes where the nerves exit.
This would decrease the pressure placed on the spinal nerves. However, like all surgeries, there is no guarantee either. If your symptoms disable you, this may be an option. A trusted spinal surgeon would discuss surgical options.