Description

Spinal stenosis occurs when the space in the interior of the spinal column is too small. This can put pressure on the spinal cord and the nerves that travel through the spine. Spinal stenosis occurs most often in the lower back and the neck.

Some people with spinal stenosis do not have symptoms. Others may experience pain, tingling, numbness and muscle weakness. The symptoms may get worse over time.

The most common cause of spinal stenosis is the wear and tear of the damage in the column related to arthritis. People who have serious spinal stenosis, surgery may be needed.

The surgery can create more space on the inside of the spine. This may relieve symptoms caused by pressure on the spinal cord or nerves. But the surgery can't cure arthritis, so the pain of the arthritis in the spine can continue.

Symptoms

Spinal stenosis often causes no symptoms. When symptoms do occur, they begin slowly and get worse over time. The symptoms depend on which part of the spine is affected.

In the lower part of the back

Spinal stenosis in the lower back can cause pain or cramping in one or both legs. This occurs when you are standing for a long time or when you walk. Symptoms improve when you bend forward or sit down. Some people also suffer from back pain.

In the neck

Spinal stenosis in the neck can cause:

  • Numbness.
  • Tingling or weakness in a hand, leg, foot, or arm.
  • Problems with gait and balance.
  • The neck pain.
  • Problems with bowel or bladder.

Causes

The bones of the spine are stacked in a column from the skull to the coccyx. Protect the spinal cord, which runs through an opening called the spinal canal.

Some people are born with a small spinal canal. But the majority of spinal stenosis occurs when something happens to reduce the amount of open space within the spinal column. Causes of spinal stenosis include:

  • The bone spurs. The wear damage of arthritis can cause extra bone to grow into the spinal column. This creates bone spurs that can push into the spinal canal. Paget's disease can also cause extra bone to grow into the spinal column.
  • The herniated disk. Discs are the soft cushions that act as shock absorbers between the bones of the spine. If part of the disk of the soft inner material is filtered, you can press on the spinal cord or nerves.
  • Thickness of the ligaments. The strong cords that help keep the bones of the spine together, can become stiff and thick over time. Thickness of the ligaments can push into the spinal canal.
  • Tumors. Rarely, tumors may form in the interior of the medullary canal.
  • Injuries of the spinal cord. Car accidents and other trauma can cause the spine bones to break or slip out of its place. The swelling of the tissue close to the right after the back surgery, can also exert pressure on the spinal cord or nerves.

Risk factors

Most people with spinal stenosis are more than 50 years of age. Younger people may be at greater risk of spinal stenosis if you have scoliosis or other spine problems.

Diagnosis

Your health care professional may ask about your symptoms and medical history. You can have a physical examination. You may also need an imaging test to help find the problem.

Imaging tests

These tests may include:

  • The x-ray An x-ray of the back can show changes in the bones that may be causing the space within the spinal canal smaller. Each one of the X-ray involves a small dose of radiation.
  • Magnetic resonance imaging (MRI). An mri uses a powerful magnet and radio waves to produce detailed images of the soft and hard tissues. The test can detect damage to the disks and ligaments. It can also show if the tumors are present.
  • The computed tomography (CT). If you can not have an mri , you may need a ct scan. This test combines X-ray images taken from different angles. In a CT myelogram, a contrast material that is injected into the contour of the spinal cord and nerves. This may show a herniated disc, bone spurs, and tumors.

Treatment

The treatment for spinal stenosis depends on the severity of your symptoms.

Medications

Your health care professional may prescribe:

  • Nonsteroidal anti-inflammatory drugs (Nsaids). If analgesics do not provide sufficient relief, the prescription of Nsaids may be helpful.
  • Antidepressants. Night dose of the tricyclic antidepressants, such as amitriptyline, can help relieve chronic pain.
  • Anti-seizure drugs. Some anticonvulsants, such as gabapentin (Neurontin, Gralise), are used to reduce the pain caused by damaged nerves.
  • Opioids. Medications such as oxycodone (Oxycontin, Roxicodone, others) can be used, but may be habit forming.

Physical therapy

A physical therapist can teach you exercises that may help:

  • Increase your strength and endurance.
  • To maintain the flexibility and stability of the spine.
  • Improve your balance.

Steroid injections

Its nerve roots may become irritated and swollen in places where they are being pinched. The injection of a steroid medication into the space around the pinched nerve can help reduce the swelling and relieve the pain.

However, steroid injections may not be the best option for spinal stenosis. Some studies have shown that combined injections of steroid and an anesthetic to relieve the back pain is not better than the injections of anesthetic alone.

This is important because steroids can cause serious side effects. Repeated injections of steroids can weaken near the bones, tendons, and ligaments. That is why a person, they often have to wait several months before you receive another injection of steroids.

Needle procedure for the thickening of the ligaments

Sometimes, the ligament in the back of the lower part of the vertebral column, also called the lumbar region of the spine, gets too thick. Needlelike tools inserted through the skin it can remove some of the ligaments. This can create more space in the spinal canal to reduce the pressure on the nerve roots. You may be given a medicine to help you feel calm during the procedure. A lot of people can go home the same day.

Surgery

Surgeries to create more space within the spinal canal may include:

  • The laminectomy. This surgery removes the rear of the affected spinal bone. This part of the bone called the lamina. This process eases the pressure on the nerves, making more space around you. Sometimes, the bone may need to be linked to near the bones of the spine with metal hardware and a bone graft.
  • Laminotomy. This surgery removes only the part of the picture. The surgeon creates a hole large enough to relieve the pressure on a specific point.
  • Laminoplasty. This surgery is performed only in the bones of the spinal column in the neck. This makes the space within the spinal canal largest by creating a hinge in the film. Metal Hardware closes the gap in the open section of the spine.

In most cases, these operations help to reduce the symptoms of spinal stenosis. But some people the symptoms stay the same or get worse after surgery. Surgical risks include:

  • Infection.
  • Blood clot in a leg vein.
  • Tearing of the membrane that covers the spinal cord.

Lifestyle and home remedies

Your health care professional may suggest:

  • Pain relievers. Medicines you can buy without a prescription, such as aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) and acetaminophen (Tylenol, others) — may help to reduce pain and swelling.
  • The loss of weight. Losing excess weight can reduce the pain by taking some stress out of the lower part of the back.
  • Exercise. Stretching exercises and strengthening can help relieve the symptoms. Talk with your health care team about what exercises are safe to do at home.
  • Walking aid. In addition to providing stability, canes and walkers can help relieve the pain so that you forward when you walk.

Alternative medicine

Integrative medicine and alternative therapies can be used with conventional treatments to help deal with spinal stenosis pain. Examples include:

  • Massage therapy.
  • The chiropractic treatment.
  • Acupuncture.

Preparing for your appointment

You may be referred to a doctor who specializes in disorders of the nervous system, called a neurologist. Depending on the severity of your symptoms, you may also need to see a surgeon spinal, what could be a neurosurgeon or an orthopedic surgeon.

What you can do

Before the appointment, you might want to prepare a list of answers to the following questions:

  • When did you first notice this problem?
  • Has gotten worse with time?
  • Your parents or siblings had similar symptoms?
  • Do you have any other medical problems?
  • What medications or supplements that you take regularly?
  • What spine surgeries or injections have had?

What to expect from your doctor

Your health care professional may do some of the following questions:

  • Do you have pain? Where is it?
  • Any position to alleviate the pain or make it worse?
  • Do you have any weakness, numbness or tingling?
  • Do you feel more clumsy lately?
  • Have you had any trouble controlling your bladder or bowels?
  • What treatments have already tested for these issues?
Symptoms and treatment of Spinal stenosis