Understanding Spinal Stenosis

spinal stenosis

Spinal stenosis is a narrowing of the spinal canal resulting in a lack of space to accommodate the nerves.

The spinal canal contains the nerves that connect to the skin and muscles of the legs. A normal size canal has sufficient space to hold these nerves. But, as a person ages, the canal is subject to narrowing. The narrowing may not always result in problems. But if the narrowing causes pinching of the spinal nerves, problems will develop.

Spinal stenosis isn't always caused by degeneration due to age. It can also be due to tumors, herniated discs, and injuries resulting from accidents. Spinal stenosis can even be present at birth but this is rare.

The symptoms of spinal stenosis vary depending upon the location of the compressed nerve. If the nerves in your neck or shoulder are pinched, you will experience pain in this area.

If the pressure is on the nerves that control your balance, you will tend to be clumsy or fall easily.

When the stenosis results from a herniated disc, the pain will begin in your hip or buttocks and travel down the back of your leg. In this case, the pain is confined to one side of your body but increases when you sit.

If the pinched nerves are in your lower lumbar region, you can have a condition known as false claudication. People with this problem have pain and cramping in their legs make it difficult to stand straight in one position for long periods of time. Sitting down relieves the discomfort. Walking is easier when bending forward which is why many people with spinal stenosis prefer to shop at stores that have shopping carts. Leaning forward on the cart makes walking much easier. False claudication also makes downhill walking difficult.

There is another form of claudication called vascular claudication, which is a blockage in the arteries in the legs. This also causes pain and cramping but unlike false claudication, it gets worse when walking up hill and gets better when you stand still.

Other symptoms of spinal stenosis are numbness in the arms, hands, feet, or legs and loss of bladder or bowel control. People who experience the numbness need to be careful, as it is possible to injure the body part and not be aware of it due to reduced sensitivity.

Anyone have problems with bowel or bladder control need to consult their physician immediately.

Doctors use radiographs and MRI's (magnetic resonance imaging) to diagnose spinal stenosis. The radiographs show whether arthritis is present and if there is any slippage of the vertebrae. The MRI scan is needed to detect whether or not there is any pinching of the nerves. There are also special tests available for people who cannot have an MRI.

There are two basic types of treatment for spinal stenosis - surgical and nonsurgical.

Nonsurgical treatments involve physical therapy, anti-inflammatory medication, and epidural steroid injections.

People need to be cautious about the anti-inflammatory medications as many of these have serious side effects. They should be thoroughly discussed with the doctor prior to taking the medications.

The steroid medication is injected directly into the nerve roots within the spinal canal. There are less side effects with this treatment and sometimes it will allow patients to avoid surgery.

The non-surgical treatments are only useful for providing relief from symptoms. They do not decrease the narrowing of the canal.

There are two types of surgical treatments. One, called decompression, consists of removing the bone and soft tissues that are pinching the nerve.

The other involves a spinal fusion during which two or more vertebrae are permanently fused together.

Surgery is usually viewed as a last resort to be attempted when all other treatments fail. However, if there is loss of bladder or bowel control, surgery will be performed immediately.