Spinal Stenosis

The causes of cervical stenosis and lumbar spinal stenosis are similar. In many cases, osteoarthritis can cause spinal stenosis, but there are a range of other reasons why someone may develop spinal stenosis:

• Bone spurs, which often develop from excessive wear and tear on the vertebra
• Paget’s disease, a condition that causes abnormal bone growth in the spine
• A herniated disk, which is when the cartilaginous material between the vertebrae slips out of place and covers the space within the bone
• Overly thickened ligaments that protrude into the spinal column
• Tumors that cover all or part of the spine
• Trauma to the spine, including fractures, dislocations, or recent back surgery

While people who are most likely to suffer from spinal stenosis are those over the age of 50, younger people may also be at risk, especially if they have experienced trauma, birth defects that impact the spine, or conditions such as scoliosis.

Your doctor can diagnose spinal stenosis based on a comprehensive examination. This typically involves reviewing medications and taking a medical history. Doctors usually complete a physical exam that may involve recreating painful circumstances that help them determine the root of the problem.

Imaging tests such as x-rays, magnetic resonance imaging (MRI), and computerized tomography (CT) scans are also helpful in diagnosing cervical and lumbar spinal stenosis. These tests all give doctors a clearer and more detailed view of the tissues and bones in the spine so they can look for abnormalities or other issues.

The spinal stenosis symptoms someone may experience can be directly related to the severity of their condition. As a result, some people with minor spinal stenosis may experience low levels of pain and some mild difficulty walking. On the other hand, people who have severe narrowing of the spinal area are likely to experience excruciating pain and difficulty moving. Research has shown that once symptoms start, no matter how mild they may be, they are likely to worsen over time. The symptoms of spinal stenosis include:

• • • Lack of sensation and a feeling of pins and needles, also known as numbness or tingling (depending on where the stenosis is, this may occur in the arms and legs as well as the hands and feet)
    • Weakness (again, depending on the location, this can cause low strength in the arms and legs as well as the hands and feet)
    • Back pain or neck pain
    • Cramping in the neck or back
    • Difficulty walking
    • Poor balance and coordination, also known as clumsiness
    • Concerns related to the bowel or bladder, including urgently needing to urinate, inability to control urination, and inability to control defecation

Every person differs so, while some people may experience numbness or weakness from the start, others may only have slight issues that don’t cause pain at the onset of the condition.

One of the surgeries that doctors might recommend in cases of severe spinal stenois is percutaneous image-guided lumbar decompression (PILD). This is a surgical procedure that involves using small needles to remove parts of thickened ligament that are blocking the spinal cord.

For this reason, PILD surgery is only suitable for people who have lumbar stenosis that is caused by a thickened ligament, since it’s not usually safe to remove other vital structures that are part of the spinal cord.

Another series of spinal stenosis surgeries involves removing portions of the bone itself to make more space for the spinal cord. A laminectomy removes the rear part of the vertebra, a laminotomy removes a section of the rear part of the vertebra, and a laminoplasty takes away part of the cervical vertebra before creating a “latch” that allows for more room in the middle.

Each of these surgeries may also be combined with another procedure called a spinal fusion, which involves melding two bones together to provide pain relief and added stability.

These surgeries are scientifically sound and have been performed for years. However, they can be costly, involve lengthy recoveries, and offer no guarantees that symptoms will not return.

Conservative, or nonsurgical, treatments are a highly viable option for people living with spinal stenosis. In addition to non-steroidal anti-inflammatory medications (NSAIDs) and steroid injections, chiropractic care and physical therapy are highly effective options for treating spinal stenosis.

A physical therapist or a chiropractor will complete a thorough evaluation before guiding you through exercises and activities designed to strengthen your spine, improve mobility and motion, and relieve pain. These programs can also increase flexibility and build endurance.

These professionals may also offer medical advice to help with the recovery process, including maintaining a healthy weight to relieve pressure on the spine and using assistive devices to increase function.

Chiropractors and physical therapists can also rehabilitate people living with other conditions such as arthritis and musculoskeletal disorders.