Spinal Stenosis

Spinal stenosis is a narrowing of the spinal canal that causes pressure on nerves traveling to the legs and arms.  Some people are born with the condition, while others have wear-and-tear on the vertebrae (spine bones).  Some patients do not show any symptoms, while others feel pain, numbness, tingling, muscle weakness, and problems controlling bladder and bowel functions.

Symptoms

Patients can show evidence of spinal stenosis on X-Rays in the lower back and neck.

Lower Back

Lumbar stenosis can cause leg pain or cramps from walking, exercising, or standing for a long time.  The pain can be relieved by patients stretching, sitting, or lying down.

Neck

Cervical stenosis can cause radiating pain, numbness, or weakness in the leg, foot, arm, or hand.  Some patients struggle to walk, maintain balance, and control their bladder or bowels.

Causes

The main causes of pain are the result of bone overgrowth, herniated discs, thickened ligaments, tumors, or spinal injuries.

Bone Overgrowth

Wear and tear damage from osteoarthritis or Paget’s disease cause bone spurs to grow into the spinal canal, irritate nerves, and cause pain.

Herniated Discs

Damage to the gel pad discs can irritate, pinch, or apply pressure on the spinal cord nerves.

Thickened Ligaments

Over time, the tough connective tissue that holds the spine bones together can become stiff, thicken, or bulge into the spinal canal.

Tumors

Tumors cause nerve pressure and pain when they grow inside the spinal cord membrane covers, or between the spinal cord and vertebrae.

Spinal Injuries

Sports injuries, car accidents, or major trauma can dislocate or fracture vertebrae, and damage the spinal canal.  Swelling and tissue damage from back surgery can also put pressure on the spinal cord nerves.

Treatments

Patients have a variety of treatments to choose from including self care, medications, therapies, procedures, and surgeries.

Self Care

Physical therapy and exercise are not a cure for spinal stenosis, but can help improve mobility and weight management to prevent inactivity problems from arising.

Medications

Patients can try over-the-counter (OTC) acetaminophen (Tylenol) or anti- inflammatory (ibuprofen or naproxen) to reduce mild to moderate pain. If the pain doesn’t improve, physicians can treat the nerve pain with opioids (OxyContin) or anticonvulsants (Gabapentin). Muscle spasms can be treatement with relaxers (Valium), and antidepressants (amitriptyline) can help psychological conditions that make the perception of pain worse.

Therapies

Physicians might recommend physical therapy to improve posture, sleeping, ergonomics, stretching, and exercises that improve mobility and reduce pain. Psychotherapy and meditation can help cope with depression, anxiety, or exhaustion that makes pain worse.

Steroid Injections

A physician can inject anti-inflammatory medication directly on the nerve to reduce irritation and pain.  Steroid injections don’t work for everyone and repeated treatments can weaken nearby bones and tissue.

Spinal Cord Stimulation (SCS)

Spinal cord stimulation (SCS) delivers mild electrical stimulation to nerves along the spinal column minimizing the sensation of pain.  A minimally invasive and drug-free treatment option, SCS is a FDA approved therapy with proven results.  The treatment has been used successfully for 30 years, and includes a 3-10 day trial period to ensure success before surgically implanting in the body.

Surgery

For some patients, surgery is a consideration if conservative treatments fail and activities of daily living are significantly disrupted.  Surgery can relieve pressure on the spinal cord or nerve roots by increasing the space within the spinal canal.  This can include removing the back part of the vertebrae (Laminectomy), carving a hole to relieve pressure (Laminotomy), or creating a hinge in the neck lamina (Laminoplasty) to open up space.

Specialists

These doctors specialize in spinal stenosis and can help diagnose, treat, and manage your condition.

Anesthesiologist

A doctor that administers medicine to put patients asleep during surgery, renders them numb for local procedures, or reduces chronic pain through injections.

Physiatrist

A doctor specializing in physical medicine and rehabilitation that treats both acute and chronic pain with a variety of nonsurgical treatments.

Neurosurgeon

A surgeon that diagnoses and treats pain resulting from disorders of the spine, spinal cord, nerves, brain, intracranial, and intraspinal vasculature.

Orthopedic Surgeon

A surgeon that diagnoses and treats pain resulting from spinal disorders, arthritis, sports injuries, trauma and fractures.

Learn More:
Mayo Clinic
Spine Health

Use the lower back pain scale to monitor your condition daily.