Anatomy & Background
Spinal stenosis is a common condition found in adults 50 and older in which your spinal canal will start to narrow. Your spine is made of a series of vertebrae which protects your spinal cord. For many people, stenosis is caused by arthritis, due to the spinal canal tendency to narrow when dealing with these arthritic problems.
As the spinal canal narrows, the tightening can pinch the spinal cord and verse around it, causing pain, tingling, or numbness in your legs, arms, or torso.
As the discs in your back degenerate and loses water content due to arthritis, the discs will begin to dry out and weaken. This causes the collapse of disc spaces and the loss of disc space height. Further, as these discs settle, weight is both transferred to the facet joints and the tunnels that the nerves exit through becoming smaller.
To make up for the lost cartilage, the body can respond by growing new bone in your facet joints to help support the vertebrae. Down the line, bone spurs may develop and narrow the space for nerves to pass through. The pain people feel between the bone spurs, and this narrow space is spinal stenosis.
While spinal stenosis produces the usual pain associated with back pain, numbness and stiffness, additional symptoms may include:
- Sciatica pain.
- Foot drop.
- A hard time standing or walking.
- Loss of bladder or bowel control.
Medical History and Physical Examination
A doctor will examine your back after discussing your symptoms and medical history. This includes looking at your back and applying pressure on different areas to see if it hurts. Your doctor may have you bend forward, backward, and side-to-side to look for limitations or pain.
Other tests that will help confirm a spinal stenosis diagnosis include:
- X-ray: An x-ray can help determine if you have aging changes, like loss of disc height or bone spurs. X-rays can also show instability in your joints.
- MRI: This study helps create better images of soft tissues such as muscles, discs, nerves, and the spinal cord.
Treating Spinal Stenosis
Nonsurgical treatment options focus on restoring function and relieving pain. Although nonsurgical methods do not improve the narrowing of the spinal canal, many people report that these treatments help relieve symptoms. A few nonsurgical solutions Redefine Healthcare suggests are:
- Physical therapy
- Lumbar traction
- Anti-inflammatory medications
- Steroid Injections
- Chiropractic manipulation
Surgery for lumbar spinal stenosis is reserved for patients who have a lot of pain and weakness. Patients may complain of difficulty walking for extended periods. This is often the reason that patients consider surgery. The two main types of procedures for spinal stenosis are:
- Laminectomy – Also called a “decompression,” a laminectomy can be performed as open surgery. The process can also be done using a minimally invasive method, where several smaller incisions are made. Your doctor will discuss the right option for you.
- Spinal fusion – If arthritis has progressed to spinal instability, a combination of decompression and stabilization or spinal fusion may be recommended.
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