What is Spinal Stenosis?
Spinal stenosis (or narrowing) is a common condition that occurs when the small spinal canal, which contains the nerve roots and spinal cord, becomes compressed. This causes a “pinching” of the spinal cord and/or nerve roots, which leads to pain, cramping, weakness or numbness.
Causes of Spinal Stenosis
The cause is usually wear and tear, past injury, disk rupture (herniation), or osteoarthritis related to aging. As disks between vertebrae wear out, spaces between vertebrae narrow. Vertebrae become deformed and may develop spurs (bony outgrowths or bulges) that can compress spinal nerves.
Symptoms of Spinal Stenosis
Symptoms depend on which area of the spine is narrowed. Narrowing of the lower part produces pain in the lower back, buttocks, and thighs. In severe cases, legs or arms may become numb and weak.
Pinching (compression) of a spinal nerve root may cause intense pain in the buttocks or down the leg. Sciatica means pain in the leg caused by pinching, swelling (inflammation), or injury of the sciatic nerve. This nerve runs from the lower spine, down the buttock and back of the knee to the foot. Numbness and pins and needles may also be felt.
Spinal stenosis pain is worse during walking (especially downhill) or standing and gets better by bending forward.
How is Spinal Stenosis Diagnosed?
A medical history and physical examination are used for diagnosis. The health care provider may order blood and urine tests to see whether another disorder may be causing symptoms. X-rays of the spine will be done. Magnetic resonance imaging (MRI) of the spine may be done if a better picture is needed of bones, nerves, disks between vertebrae, and other tissues, or if surgery is being considered. A nerve conduction test may tell whether pressure on nerves is causing numbness or tingling in the legs.
Treatment of Spinal Stenosis
Physical therapy may help reduce pain and improve mobility.
Over-the-counter pain relievers, such as acetaminophen, or nonsteroidal antiinflammatory drugs (NSAIDs), such as ibuprofen, can help. For really severe pain, stronger narcotic medicines may be used for a short time. All drugs have side effects. NSAIDs may cause stomach upset, rash, and internal bleeding. Narcotic drugs may also cause drowsiness and constipation and can be habit forming.
Surgery is used only for pain that doesn’t go away. The operation may remove the disk (diskectomy) to relieve pressure on a nerve, or remove part of the bony arch, or lamina, of a vertebra (laminectomy) for a herniated disk. Removal of the vertebral body and surrounding soft tissue is called decompressive laminectomy. In people with spinal stenosis and instability of the spine, bone graft to maintain the structural support of the spinal column (spinal fusion) may be done following decompressive laminectomy.
Dos and Donts in Spinal Stenosis (Can be linked to Bone Health Guide)
DO take medicines as prescribed.
DO call your health care provider if you have drug side effects.
DO call your health care provider if you have new numbness or tingling in your legs.
DO call your health care provider if you have trouble urinating or lose control of your bowels or bladder.
DON’T wait for a drug side effect to go away on its own.
DON’T stop exercising completely.