Spinal Stenosis: Symptoms, Causes, Diagnosis, Treatment

Evidence Based Article đź“„
This article has been based on relevant and up-to-date scientific studies. Our writers are unbiased and objective and present the facts as they are known. Numbers in brackets within the article refer to sources included in the reference list at the end of the article.

The condition that mostly affects people over 50 years old, spinal stenosis is an abnormal narrowing in the spinal canal that causes discomfort, chronic pain, and a wide range of other health issues.

This condition is incurable, yet there are several nonsurgical and surgical treatments that can help to relieve the pain and discomfort. Below is everything you need to know about spinal stenosis and useful tips how to deal with its symptoms.

What’s Spinal Stenosis?

Also called foraminal spinal stenosis, central spinal stenosis, and pseudo-claudication, spinal stenosis can affect any area of the spine.

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The gradual process where the spinal column starts narrowing and compressing the spinal cord is called spinal stenosis.

The minimal narrowing doesn’t cause any harsh symptoms while a big narrowing can begin to compress the nerves, causing a series of health problems and mild or severe spinal pain.

The spine is a number of bones stacked on the top of each other – they’re called vertebrae – that support the upper body and provide the whole body stability. Without it, we wouldn’t be able to turn and twist.

Running through the openings in the vertebrae, the spinal nerves are responsible for conducting the signals from the brain to the body. The surrounding tissues and bone provide a full protection to these nerves. However, once they’re impaired or damaged in, it can seriously affect important functions, such as sensation, balance, and walking.

For many adults, spinal stenosis results from the changes caused by arthritis. This leads to spinal canal narrowing, making the open spaces between the bones get smaller. Discomfort, pain, numbness, or tingling in the torso, arms, or legs generally follow.

What Are the Symptoms of Spinal Stenosis?

The symptoms of spinal stenosis greatly depend on the area in the spinal canal where the stenosis occurs and how serious it is.

The symptoms usually progress in due course, when nerves become more and more compressed.

Myelopathy is the symptoms that occur as a result of the compression of the spinal cord and they include:

  • loss of control of the bowel;
  • loss of control of the bladder;
  • difficulty picking up small coins or buttoning buttons;
  • dropping objects;
  • falling;
  • worsening balance.

Radiculopathy includes the symptoms that occur as a result of the compression of the nerves. They are:

  • weakness or a slight numbness along the path of the compressed nerve;
  • tingling and pain in certain area of the spine.

Cervical spine stenosis is a condition when the stenosis develops in the neck, causing the compression of the spinal cord along with the nerves traveling into the hands and arms. This usually leads to the symptoms of myelopathy as well as weakness, tingling, cramping, or numbness in the hands and/or arms.

Lumbar spine stenosis is a condition when the stenosis affects the lower back, causing the compression of the nerves traveling into the feet and legs. This leads to weakness, tingling, cramping, or numbness in the feet and/or legs, especially during the walk. The symptoms are often referred to as false blockage (pseudoclaudication) because they imitate the symptoms of poor circulation to the legs called claudication.

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What Are the Causes of Spinal Stenosis?

Aging is the biggest cause of spinal stenosis, albeit not everyone develops this condition as they get older. Some people over 50 years old are more prone to developing spinal stenosis than others. Those who have a relative in a family history who suffered from spinal stenosis or any other spinal issues are at a high risk of spinal stenosis due to their genetic trait.

People, like athletes or heavy laborers, who overload their backs are also at a higher risk than those with a more sedentary lifestyle. Additionally, spinal stenosis can affect individuals with certain connective tissue conditions, including anhylosing spondylitis.

The soft and bony tissue changed because of aging, also called degenerative arthritis, is another common cause of spinal stenosis. The typical “wear and tear” of aging can jamp start the development of arthritis in the back, leading to spinal stenosis. It can happen when the ligaments between the vertebrae begin to thicken, or because of wear and bulging of the intervertebral discs and/or osteophytes (bone spurs) forming.

Oftentimes, a raised motion happening between the vertebrae leads to one vertebra slipping forward on another. The condition is called spondylolisthesis, and it might be one of the causes of spinal stenosis too.

Some other conditions that may lead to stenosis are:

  • A kind of dwarfism called achondroplasia;
  • Bone tumors;
  • Paget’s disease of the bones that leads to abnormal bone regrowth and destruction;
  • Scoliosis, or spinal curvature;
  • A narrow spinal cord by nature;
  • Any spine defects happening at birth;
  • Any spinal injuries;
  • Herniated discs.

How Is Spinal Stenosis Diagnosed?

Once you have noticed any symptoms of spinal stenosis or you start suffering from severe spinal pain, you should immediately see your doctor. They will check your medical history to find the possible causes of your back pain and perform a physical exam to observe your movements. They’re more likely to ask you to do several tests to check and confirm that you’re having spinal stenosis. The most common tests done include:

  • bone scan to check out and determine any growths or damage in the spine;
  • electromyelogram that allows to determine the health of the spinal nerves;
  • CT scan, MRI scan, or X-ray to see the whole picture of the spine and detect any possible changes or damages.

What’s Treatment of Spinal Stenosis?

When you’re diagnosed with spinal stenosis, it doesn’t mean you’re going to need a certain surgery treatment. Doctors mostly start with nonsurgical treatments, unless you have some serious complications or conditions.

The most common nonsurgical treatments are:

  • Pharmaceutical treatment. It involves the usage of certain medications to relieve the pain, such as aspirin, naproxen, ibuprofen, and acetaminophen. Unfortunately, these medications provide a short-term relief only. The anti-seizure medications and muscle relaxants might also be prescribed to treat the most harmful aspects of spinal stenosis, including damaged nerves and muscle spasms. In order to reduce the swelling in the spinal column, a doctor can prescribe corticosteroid injections. This is an injection of a steroid like prednisone into the neck or back that helps to beat inflammation. However, steroids must be used sparingly since they have a host of serious side effects. The same goes for anesthetics, the injections of a “nerve block,” which are used in extreme cases to decrease the pain.
  • Physical therapy. Exercise helps to gently stretch the body and strengthen muscles. Because of the pain, you may not feel like working out at all, but exercise must become a part of your daily routine since it’s vital for your overall health. Aim to do a few stretching exercises 2 to 3 times a day. It’s important to start slowly and not overdo it. Your doctor will create special exercises to relieve your symptoms. It’s typically recommended to work out 3 times a week for at least 30 minutes. If you haven’t been moving your body for a while though, begin with 3 to 5 minutes a day and gradually increase the time. If you experience a severe pain during physical therapy, your doctor may suggest you exercise in a pool. Thanks to the buoyancy of water, you’ll be able to move easier and get full range of motion. This will help you improve the balance and boost your flexibility.
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Avoid performing any exercise without consulting a physical therapist or a doctor first. They’ll create a workout routine that will target your abdominal and back muscles and help to loosen up the back muscles, providing overall relaxation. If your spinal stenosis has certain complications, you’ll need to use a back brace for an additional support.

  • Maintain a good weight. Overweight and obese people tend to have more spinal stenosis complications, including chronic pain, than those with a healthy weight. Be sure to stick to a healthy diet and drop a few extra pounds if needed.
  • Improve your posture. Consider sleeping on a firm mattress and be sure you stand up and walk straight. If you need to sit the whole day, invest in a quality supportive chair to prevent the pain.
  • Cold and warm compress. Cold compress will help you decrease inflammation while a warm one will loosen up the muscles. Apply it to your lower back or neck to diminist the symptoms of spinal stenosis.
  • Chiropractic manipulation. Chiropractic treatment is an effective and safe option for people who are looking for a natural and alternative method to handle spinal stenosis. Chiropractic manipulation must be performed only by a professional to avoid any complications. The most widely-used techniques are traction methods, chiropractic spinal adjustments, flexion-distraction techniques, and spinal decompression therapy. Not only does chiropractic treatment provide a quick relief to the stenosis symptoms, but also have little to no side effects and reduce the risks of surgery or epidurals. The flexion-distraction method has been shown to provide the pain relief for individuals with spinal canal stenosis. The flexion-distraction technique helps to open the spinal canal space, reducing the pressure within the discs and realigning the joints to restore or support a good motion.
  • Massage. A medical massage can also help people suffering from spinal stenosis. It helps to reduce the pressure, beat the pain, and improves the blood circulation. Be careful with this method though, a massage done in a wrong way may even require a surgical treatment. Look for a professional or ask your doctor to recommend an excellent medical massage expert.
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Surgery is required for stopping the severe pain or to fix a neurological loss. Professional and successful surgical treatments help to get rid of the pressure permanently. However, any type of spinal surgery is risky and requires a certain recovery time. The biggest dangers of a surgery are blood clots, infection, and an injury to one or several nerve roots. The most common surgical treatments are:

  • Spinal fusion. Done in severe cases, particularly when several spine levels are involved. Metal implants or bone grafts are used from your pelvic bone to lock or stabilize two or more bones in order to prevent them from moving. The spinal fusion treatment requires a long recovery process. You may find it hard to bend after the treatment, but a special exercise program will help you recover faster. Spinal fusion can also involve a minimally invasive procedure, where the spacers are inserted between the superior and inferior spinous processes in order to keep the space open and the vertebrae apart.
  • Discectomy. When a certain part of a spinal disk is compressing the spinal nerves, a discectomy treatment may be required. The surgeon uses a small incision to remove the part of the disk that causes the pain or discomfort.
  • Laminectomy. The most popular type of the spinal stenosis surgery treatment, laminectomy involves the removal of the part of the vertebrae to ensure more space for the nerves. The surgeon performs an incision to get an access to the spine. After that, ligaments, bone spurs, or anything that places a pressure on the nerves are removed or trimmed. Even though this surgical treatment doesn’t require a long recovery, it’s still important to follow the doctor’s requirements.
  • Foraminotomy. This is another commonly used surgical treatment that involves the process of widening the area of the spine, especially the cervical spine, where the pairs of nerves exit. The recovery process after this procedure depends on how successful the surgery is and can take up to a week to recover.

Spinal stenosis is a serious health condition that requires a special treatment, so if you think you are at a high risk, visit your doctor and start treating the problem today. This can help you improve your health without turning to surgical treatments. Remember, your diagnosis isn’t the end of the world. There are a lot of both women and men with spinal stenosis who enjoy the full lives and stay active in the gym.