Spinal Stenosis - Reasons and Treatment Options

spinal stenosis

Spinal Stenosis is a medical condition that is found mostly in elderly people. The spinal canal, which stretches from the bottom of the head to the top of the pelvis, might become narrow and the spinal cord and nerves get compressed. This causes low back pain, pain or numbness in legs, thighs and buttocks, and sometimes loss of bladder and bowel control in severe cases.

The spinal canal consists of a number of vertebrae aligned together like a stack. The spinal canal may be divided into cervical spine (in the neck), thoracic spine (the mid back) and lumbar spine (the lower back). The spinal cord passes though the spinal canal. There are nerves coming out from the spinal cord and between the openings (known as foramen) in vertebrae, spreading out to the whole body. The nerves from spinal cord in the cervical region control the arms the nerves from spinal cord in the lumbar region control the legs. Spinal Stenosis is more common in cervical and lumbar spine. Lumbar spinal stenosis causes pain and numbness in legs whereas cervical spinal stenosis can cause pain and numbness in arms, shoulders and legs.

The foremost reason for narrowing of the spinal canal is a gradual degeneration of the spine with age. The gradual changes in bony and soft tissues of the spine may result in spinal stenosis. Osteoporosis or a tumor can also put pressure on the spinal cord and nerves. Arthritis can settle in with age and also affect the spine. This can cause cartilage wear and tear between the bones on the joints of the vertebral column. The discs between the vertebrae might bulge out or ligaments can also thicken in some cases. This cramps the space available for spinal nerves and spinal tissues, resulting in pain and numbness in lower back or legs. Such arthritis only worsens with time and if not treated promptly, can result in loss of bladder and bowel control. If one vertebra slips forward on another, that can also cause spinal stenosis.

Treatment for spinal stenosis depends on the severity of the condition. It is always advisable to start with a non operative course. Medication needs to be taken to reduce inflammation and pain. Some medications meant for nerve pain are particularly helpful. Physiotherapy can also be tried as a treatment option. Application of hot and cold packs can also help. Steroid injections for the lumbar spine can provide relief but should be taken in moderation. A corset can be worn to support the abdominal muscles.

If there is no improvement with these treatments or if the patient experiences loss of bladder and bowel control, it is better to opt for surgery to avoid damaging the spinal tissues permanently. Generally, Lumbar Decompression Surgery is needed to remove whatever might be cramping the nerves in the spinal canal or vertebral foramen. A small portion of vertebra may be removed so that spinal tissues are freed. If the number of restrictive structures to be removed is much, it can cause spinal instability. In such a case, a spinal fusion is required to attach the vertebrae together. This surgery can successfully eliminate the pain and numbness in legs.