Spinal stenosis is a condition where the spacing within the spine becomes narrow and creates pressure. Our spines change over time and the narrowing of the spinal canal is often attributed to natural degeneration. Roughly 90% of people will experience some form of lower back pain at some time in their lives. In the United States, it is estimated that more than 250,000 people exhibit signs specific to spinal stenosis. This equates to approximately five of every 1000 people over the age of 50.
Understanding the Spine
The spine plays a significant role in our overall well-being. It supports our upper body, shoulders, and head. The spine is critical in our ability to maneuver and bend. The spine can be described as having three curved parts. The cervical spine is a “c-shaped” segment in the neck region. The other two are the lower lumbar spine and the “reverse c-shaped” segment in the chest region called the thoracic spine.
The curvature of the spine is necessary for us to maintain proper balance. Any significant changes to the spine will typically have an adverse effect on our posture. When abnormalities exist, they are referred to as spinal deformities. One common example is kyphosis, which creates a “hunched” posture. Another deformity involves an abnormal curve in the spine called scoliosis.
Equally as important as the structural purposes of the spine is the role it plays in facilitating signals between the body and the brain. This is a function of the central nervous system that uses the nerves along the spine for transmitting “messages.”
The spinal canal is composed of a chain of bones known as vertebrae that are cushioned by absorbent discs of cartilage that protect the spine. When this canal narrows, spinal stenosis develops and typically the spacing between the vertebrae decreases. It is most common that people with spinal stenosis are over the age of 50 and experiencing arthritis.
Cervical vs Lumbar Spinal Stenosis
The two types of problems include cervical and lumbar spinal stenosis. Cervical stenosis occurs in the neck region while lumbar stenosis occurs in the lower back region. Lumbar stenosis is much more common.
Causes of Spinal Stenosis
- Arthritis is the most common cause of the condition. This occurs when the cartilage that separates the bones begins to erode. The term osteoarthritis is used to describe this decline in cartilage and the “thickening of the ligaments of the spine and bone spurs.”
- The bones in the spinal region also may overgrow. This growth may create the spurs that settle in the spinal canal. Paget’s disease causes these bones to enlarge and become brittle.
- Herniated disks are those that result from damage to the vertebrae. The ability to “cushion” the bones from impact declines and creates pressure and pain.
- Ligaments that are critical for connecting the bones and stabilizing the spine often thicken and create bulging that further leads to damage in the spinal canal.
- Although less common, tumors may develop in the membranes of the canal. Detection of these growths generally requires a CT scan or MRI.
- Trauma to the spinal region is a common cause of a host of spinal conditions. The impact of a car accident can cause small bones to become strained, dislodged, or fractured. Often, these injuries disrupt the vertebrae that create swelling and tissue loss that leads to subsequent problems.
Symptoms of Spinal Stenosis
It is possible that spinal stenosis is detected through a CT scan or MRI, although the individual does not experience symptoms. The spinal structure is very centralized and interconnected. When damage occurs within the system it is likely that conditions and symptoms will further worsen. Some of the most common signs that cause people to seek medical advice include:
- Numbness and tingling in the extremities
- Feelings of weakness in the hands, arms, feet, or legs
- Difficulty maintaining balance when on your feet
- Problems with pain when trying to walk
- Stiffness and soreness in the neck area
- In less common cases, the individual may have bladder or bowel problems. These include feelings of urgency to urinate or incontinence.
- Cramps may develop among those who stand for extended periods of time.
- Sciatica is a symptom where the individual may feel sudden bursts of “shooting” pain between the lower back and down through the legs.
Sciatica is a sign that there is damage to the sciatic nerve. This is a nerve that may be irritated by nerve compression in the lower spine. Those suffering from these problems tend to initially believe they have a back injury. Roughly 40% of people will have sciatica at some point in time.
Your doctor is likely to order a test to detect spinal stenosis. X-rays may provide evidence of changes in vertebrae. An MRI uses waves that generate a three-dimensional image that allows for detailed observation of potential problems. A CT scan combines the usage of x-rays and a dye that is capable of revealing damage to soft tissues.
There are both surgical and nonsurgical options available. Short-term relief from pain may be achieved with over-the-counter medications such as aspirin, acetaminophen, or ibuprofen. Prescription products such as muscle relaxers or those for treating seizures may also relieve pain and reduce pressure on the nerves. An injection of a corticosteroid may also reduce swelling but is not suited for long-term use.
An exercise regimen that involves building strength and improving the range of motion often delivers results. This form of treatment may be in conjunction with physical therapy. The importance of maintaining good posture is generally emphasized and reducing your weight also may ease pressure on your back.
Those suffering from more severe cases of stenosis may consider surgery. A laminectomy is a surgical procedure that involves removing bone fragments, bone spurs, and ligaments that are causing nerve compression. There are also emerging methods that are less invasive as well.
Spinal fusion is a surgical option that is generally used when the spine has become unstable. This procedure typically requires a hospital stay. You will likely work with a physical therapist following the procedure. The emphasis will be on building strength, often in the abdominal region to provide increased back support.
A more recent surgical process involves “interspinous process devices.” These are essentially used to separate the vertebrae and keep them properly spaced. According to the American Academy of Orthopaedic Surgery, the rate of success has risen to approximately 80% for this procedure. However, all surgical options do carry a risk of complications.
Arizona Treatment Provider for Spinal Conditions
Spinal stenosis tends to worsen over time and may be caused by multiple factors including your medical history. Our specialists at the Arizona Pain and Spine Institute are able to effectively diagnose these conditions and use a multi-faceted approach in treatment. We encourage you to contact our office today for an appointment at (480) 986-7246.