Spinal Stenosis – Causes, Symptoms and Treatment Options
Definition of Spinal Stenosis:
Stenosis stems from a Greek word that means “narrowing”. Spinal stenosis means narrowing in the spine. The most common areas that are affected are the neck (cervical) and the lower back (lumbar). This narrowing that occurs can put pressure on the spinal nerves and/or the spinal cord at that level.
Spinal stenosis can either affect the spinal canal or spaces where the nerves or nerve roots exit the spine. Pinching or squeezing of the spinal canal and/or spinal nerves can lead to pain, tingling, or numbness in your back, buttock, legs, neck, shoulders or arms; a heaviness or weakness in your limb, and possible bowel or bladder problems in lumbar stenosis.
In addition, the two main types of spinal stenosis are central canal stenosis (spinal cord area) and foraminal stenosis (nerve root area). Narrowing in the spine occurs when an enlargement or growth of a tissue or bone reduce the size of the opening in the spinal vertebra (bones). Loss of disc height (degenerative disc disease) can also decrease the size of the openings in the spine. Moreover, intervertebral discs may be pushed toward the back of the spinal canal (i.e., herniated or bulging disc) that can cause spinal stenosis.
Some of the common conditions that can cause spinal stenosis are osteoarthritis, degenerative disc disease, joint degeneration, facet or ligament arthritis or hypertrophy (growth), herniated or bulging disc, bone spurs, and bone slippage (spondylolisthesis). See below for more causes.
Causes of Spinal Stenosis
Spinal stenosis is most commonly caused from changes in the spine as people age. Steady degeneration of the spinal joints, discs and overgrowth of the soft tissues, especially ligaments, can change the size of the spinal canal and nerve space (foramen).
These are some conditions that can narrow the spinal canal
- Disk Degeneration
- Thickening of the Ligaments
- Herniated or Bulging Discs
- Bony Growths (spurs)
- Facet Joint wearing or overgrowth
- Scar Tissue
- Bone Slippage (Spondylolisthesis)
- Spinal Tumors
- Trauma to the spine, Fractures
Other conditions that may cause spinal stenosis include: inherited abnormal spinal canal narrowing, cancer, rheumatoid arthritis, Paget’s disease, DISH (diffuse idiopathic skeletal hyperostosis), compression fractures, complications from natural or surgical fusion, and Spondylosis.
Symptoms of Spinal Stenosis
Many people over the age of 55 years have some narrowing of the spine (spinal stenosis) but do not have any symptoms at all. If your spinal cord or nerve roots become pinched or squeezed, symptoms may include:
- Spinal stenosis in the lumbar spine affects the nerve roots that exit the lower back and extend to the legs. That is why the classic symptom with spinal stenosis is pain or cramping in the legs that occurs while you stand or walk and relieves when you sit down
- Low back pain or pain in the buttocks.
- Pain, tingling, numbness, or weakness in the buttocks, legs, feet, arm or hand. You may have a tendency to fall or a leg or knee might give out on you. Neck stenosis may have weakness in grip strength, or drop things.
- Stiffness or cramping in the legs, thighs, and/or calves.
- People suffering with severe spinal stenosis may have bad posture. They typically lean forward (flexed position) in a stooped position to get relief. Some people use a grocery cart to help them walk while shopping. Discomfort usually eases when you sit down.
- Loss of bladder and bowel control is an emergency that needs immediate attention.
How Is Spinal Stenosis Diagnosed?
Many doctors can diagnose spinal stenosis by doing a thorough consultation and asking you questions about your condition, symptoms, and past history. In addition, your doctor should do an exam and confirm your diagnosis with an X-ray and/or advanced imaging such as an MRI or CT.
Treatment is not only based on symptoms, but also the severity of the stenosis in the imaging results. In some cases people have severe symptoms but mild to moderate stenosis indicated on an MRI. So it is possible to have severe pain and inflammation and only have mild stenosis. Others can have mild symptoms but the test results can show severe stenosis.
That is why getting a good diagnosis from your doctor and a second opinion might be important in your decision making process.
Most of the time you can control mild to moderate symptoms of spinal stenosis with exercise, physical therapy, chiropractic care, and pain medications. If symptoms are more severe, your doctor may prescribe a spinal steroid shot to try and decrease inflammation (pain management). The most invasive option is spinal surgery, however most people do not want to take the risk of dealing with the serious complications associated with surgery. In some cases if conservative measures have exhausted surgery maybe the only solution. However, the rule of thumb for most cases, is to try conservative care first.
At the Atlas Medical Center in Irving, TX, Dr. Robert Hanson takes a different approach to resolving your pain. His Cold Laser Low Back and Neck Program combines spinal decompression therapy along with cold laser therapy and physiotherapy to provide individuals with a non-invasive, painless, and most importantly effective solution for the treatment of spinal stenosis.
If you are looking for a non-surgical solution for spinal stenosis, call our office for a consultation/evaluation to see if Dr. Hanson’s Cold Laser Program in Dallas-Fort Worth can help you.
Irving Chiropractor treats Spinal Stenosis and the associated pain at the Atlas Medical Center, with a combination of cold laser, spinal decompression, and other therapies. Spinal Stenosis pain relief in Dallas-Fort Worth metroplex.