Stenosis or Spinal Stenosis

Spinal stenosis is a condition where the space around the spinal cord begins to narrow causing the spinal cord and nerve roots to become compressed. Your spinal cord is protected by your vertebrae, which are hollow in the middle to accommodate the spinal cord and nerves. Spinal stenosis occurs when the spinal canal inside your vertebrae begins to narrow. This causes compression of the nerves and spinal cord. The neck and lower back are the two most common locations for spinal stenosis. If located in the neck, it is called cervical spinal stenosis. If located in the lower back, it is referred to as lumbar spinal stenosis. This condition is fairly common due to the natural aging process.

Spinal stenosis is often the result of natural aging and normal wear and tear on your spine. It may also be attributed to an injury or accident affecting your spine. A condition called congenital spinal stenosis is when someone is born with a narrow spinal canal and will likely worsen over time. Spinal stenosis can be the result of other spine conditions and causes including:

• Herniated disc: Occurs when intervertebral disc in the spinal column becomes damaged or ruptured. When this happens, it can put pressure on your spinal cord or nerves and can cause spinal stenosis.
• Osteoarthritis: Common condition in individuals over 50 years old that may cause degeneration or bone spurs, which can lead to spinal stenosis.
• Disc degeneration: Discs in our back begin to degenerate as we age. They lose elasticity, density, and fluid volume and small tears or cracks may appear in the outer layers of the discs, making them weak. Disc degeneration will lead to pressure on the spinal cord or nerves.
• Scoliosis: A side-to-side curvature in the spine. The curvature can easily lead to pressure on the nerves.
• Spondylolisthesis: Slippage and misalignment of the vertebrae can cause spinal stenosis.
• Bone spurs: Osteoarthritis is the most common cause of bone spurs. When bone spurs form, they will impinge on the nerves and spinal cord.
• Tumors: Abnormal growths of tissue can occur in the spinal canal. The growths put pressure on the nerves and spinal cord.

In most cases, spinal stenosis emerges as a result of degenerative arthritis. The arthritis occurs over many years as a result of daily wear and tear on the spine. Over time, this can lead to a breakdown of the connective tissue that provides cushioning between the bones of the spinal column. This, in turn, increases the risk of bone spurs that can compress the spinal column and the nerves in the spine.

The risk factors for spinal stenosis include obesity, a medical history that includes back pain or back injuries, poor posture, hypertension, and frequent overextension of the back.

Diagnosing spinal stenosis starts with a review of your medical history that includes a rundown of your symptoms. A physical exam of your back and your extremities can show your levels of joint stiffness, mobility, reported pain, and other important symptoms.  X-rays, ultrasounds, MRIs, or other imaging tests can allow your doctor to get a more accurate idea of your condition.

Most people have chronic pain from spinal stenosis, however, many of the symptoms may go unnoticed at the onset of the condition. As your condition progresses, the symptoms get progressively worse. The narrowing of the spinal canal will start to put pressure on your nerves and numbness, tingling, weakness, pain or cramping will be felt throughout your spine, down your arms and legs, or in the neck. The most common symptoms of spinal stenosis include cramps or aches in the calves. As it worsens, sufferers may have difficulty walking or standing due to the pain caused by stenosis. 

Depending on which part of your spine is affected, you may experience different symptoms. In severe cases, some may experience paralysis, loss of bladder or bowel function, or difficulty having sex. Because of the associated leg pain, spinal stenosis is often misdiagnosed at first as a circulation problem. However when therapies for circulation are used, the individual will not feel relief as the condition causing pain is spinal stenosis and not circulation.

The most conservative treatments for spinal stenosis include NSAIDs to treat pain and inflammation. Other treatments include:

• Spinal cord stimulation: mild electrical pulses sent to the spine to interrupt pain signals.
• Epidural nerve blocks: anesthetic injected into the epidural layer of the spinal cord to reduce or eliminate pain.
• Radiofrequency neurotomy: nerves involved in sending and receiving pain signals are interrupted to give you pain relief.
• Physical therapy: exercises taught to the patient to reduce pain and decrease chances of the condition worsening. Yoga is often recommended to improve spinal alignment.
• Chiropractic: adjustments can relieve pressure and pain.
• Massage: when muscle tightness is causing stress on the vertebrae, massage can help by relaxing muscles and is highly beneficial for pain relief.

The physicians at Clearway Pain Solutions work with many spinal stenosis cases and are experienced in providing you pain relief. We offer customized and individualized treatments for each patient, working to reduce pain to a minimum. To start treating your spinal stenosis, schedule a consultation with Clearway Pain Solutions.

Are you experiencing symptoms that may be spinal stenosis? Call us to request an appointment. We can diagnose the cause of your pain and create a treatment plan for you.