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Spinal Stenosis
Spinal stenosis is a narrowing of the spinal canal associated with aging and degenerative changes in the back. This narrowing of the spinal canal can cause pressure on the spinal cord or the spinal nerve roots extending out from the spine.
Spinal stenosis is most common in the lumbar spine or lower back area with the cervical spine or neck being the next most frequent site of stenosis. Spinal stenosis is the most common diagnosis resulting in back surgery. Many if not most people have some degree of spinal stenosis as they age and many of those have no pain associated with the stenosis that appears on x-rays. Paradoxically some people will have severe pain with very little stenosis appearing on their x-rays. It’s uncommon to find spinal stenosis in people under thirty and is most common after the age of fifty
Spinal stenosis is diagnosed by symptoms, physical exam, history, x-ray and MRI. Your doctor will probably want to try every possible non-surgical treatment before referring you to a specialist in spinal surgery. Statistically when based on long term pain relief as the marker of success, back surgery does not always perform very well. However, for decrease functionality issues such as loss of bowel and bladder control, loss of sexual function, paralysis, foot drop or other such issues surgery may be the only recourse and time may be of the essence in returning function.
Symptoms of lumbar stenosis include leg and buttock pain made worse by walking or standing and relieved by sitting, numbness and tingling, stiffness and back pain. Flexing forward may relieve the pain to some degree while leaning back may increase it. Cervical stenosis results in shoulder arm, hand or neck pain, numbness, tingling and weakness.
Treatment may include aerobic exercises such as stationary bike which allow you to lean forward, weight loss diet to decrease strain and progression of degeneration, medications such as Advil or naproxen and possibly narcotics. Physical therapy may be recommended to strengthen muscles and teach gentle stretching exercises. Epidural steroid injections may be used to decrease pain symptoms if medications, exercise and physical therapy fail to decrease you pain to an acceptable level. If all these non-surgical treatments fail over a reasonable period of time your doctor may then refer you to a neurosurgeon or orthopedic surgeon to be evaluated for surgery. Certainly if you are experiencing functional difficulties such as bowel and bladder dysfunction muscle wasting, sexual dysfunction, paralysis or foot drop your doctor will want you to see a specialist sooner. For these problems surgery can often be the only helpful treatment.
Spinal stenosis is a common problem associated with ageing. Maintaining an optimal weight, regular exercise, and a healthy lifestyle can decrease age related degenerative disorders and their symptoms.
Sources:
<http://www.cure-back-pain.org/lumbar-spinal-stenosis.html>
<http://orthopedics.about.com/cs/spinalstenosis/a/spinalstenosis.htm>
http://www.mayoclinic.com/health/spinal-stenosis/DS00515
This article is meant to be informative and is not medical advice. Always speak with your doctor for any questions regarding your health.
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