Insight Neurosurgery – When you stand up after sitting for an extended period or go for a walk, do you feel pain in your back, shoulders, arms, or legs? If so, you may be experiencing a problem with your spine called spinal stenosis. This condition, which currently affects as many as 500,000 Americans, occurs when the space in the spinal column narrows, compressing the nerves traveling through the lower back and legs. There are two types of spinal stenosis: Cervical spinal stenosis occurs in the neck and causes symptoms in the arms, shoulders, and hands. Lumbar spinal stenosis occurs in the lower back and causes symptoms in the legs, feet, and buttocks.
Although pain from spinal stenosis develops gradually with age, it can result in debilitating numbness, cramping, and pain – as well as weakness that gets worse when standing or walking. In this blog, we will look at some of the common causes of spinal stenosis, who it affects, how it is treated, and steps you can take to promote spine health.
Spinal Stenosis Symptoms & Causes
Wear and tear to the spine from osteoarthritis is the most common cause of spinal stenosis. Osteoarthritis is a degenerative joint disease that causes tissues to break down, resulting in pain and stiffness. In osteoarthritis-related spinal stenosis, nerves traveling to the arms and legs through small openings experience pinching or squeezing that causes pain and other symptoms. Because osteoarthritis develops slowly as we age, spinal stenosis is most common in people 50 or older.
Spinal stenosis may also be the result of a herniated disc (also known as a slipped or ruptured disc). This occurs when the gel-like material that acts as a cushion in the spine’s vertebrae starts to bulge or leak. The herniated disc then presses on the spinal cord or nerves in the spine, causing severe pain.
Another common cause of spinal stenosis associated with aging is a thickening of ligaments in the spine. In younger people, ligaments are usually strong and flexible. However, as we get older the ligaments start to harden, stiffen, and compress the surrounding nerves. This often leads to increased pressure on the spinal cord and persistent pain. Similarly, an overgrowth of bone known as bone spurs can grow in the spinal canal over time. This also causes compression on the surrounding nerves in the spinal canal.
A spinal tumor, which is an abnormal mass of tissue that surrounds the spinal cord or spinal column, is rare but can also cause spinal stenosis. The growths can put pressure on the spinal cord and spinal canal, leading to pain, numbing, and weakness in the arms or legs.
Who Experiences Spinal Stenosis?
Although some people are born with a small spinal canal, a condition called congenital stenosis, most spinal stenosis is age related. There are a number of factors that increase the likelihood of developing spinal stenosis, including:
- Age: Spinal stenosis is more common in people 50 or older.
- Gender: Women are more likely to experience spinal stenosis than men.
- Injury: People who have experienced a previous spinal injury are more likely to develop spinal stenosis.
- Genetics: People born with structural deformities to the spine may experience spinal stenosis.
- Obesity: Excessive weight subjects the spine to stress and pressure.
- Vices: Smoking and alcohol make the body susceptible to spinal degeneration.
- Lack of Exercise: Bones and tissue deterioration is more common in people who do not exercise.
Treating Spinal Stenosis
There is no cure for spinal stenosis. However, most cases can be treated effectively through a combination of nonsurgical treatments. In cases of severe pain, surgery may be necessary to treat compressed nerves in the spine. The following are some common options for treating spinal stenosis at Insight:
For many people, physical therapy plays a key role in treating spinal stenosis. Although it is not a cure, a physical therapy and exercise program gives patients resources to remain active and overcome debilitating pain. After a series of one-on-one sessions with a physical therapist, most patients can transition to an at-home program to gradually build strength, gain tolerance, and return to daily activities.
In order to alleviate symptoms related to spinal stenosis, it may be beneficial to modify activities that could trigger a recurrence. Many spinal stenosis patients are more comfortable while flexed forward. Recommended activity modification could include leaning on a walker or shopping cart instead of walking upright, using a stationary bike instead of walking for exercise, and sitting in a recliner instead of a straight-back chair. Using a neck or back brace for short periods can also offer temporary pain relief.
Depending on the severity of symptoms, your physician may recommend medications to treat spinal stenosis. Over the counter medications such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are effective at relieving pain and inflammation. Prescription strength pain medications and muscle relaxers are also options for short-term use.
Epidural Steroid Injections
Patients have also had success with epidural steroid injections that reduce inflammation at the nerve root and spinal cord. Although this treatment is temporary, it may provide enough pain relief for patients to continue physical therapy and daily activities so body strength can be restored.
Minimally Invasive Surgery
Most people who have pain from spinal stenosis will not need surgery. However, minimally invasive procedures may be considered if nonsurgical treatments have been ineffective. These types of procedures generally require smaller incisions and result in less postoperative pain. The type of surgery will vary depending on what part of the spine is being treated. As with any procedure, your physician will thoroughly explain the risks and benefits of surgery, describe what you can expect, and answer any questions you may have.
Promoting Spinal Health
There is no way to prevent spinal stenosis. In fact, most people will experience it in some form as part of the aging process. However, there are a number of steps you can take to promote spinal health and reduce the risk of developing serious complications from this condition. The following are a few suggestions you can do now to slow the advancement of spinal stenosis.
When it comes to your spine (and overall health), regular exercise is one of the best things you can do. Whether you are already physically active or are just getting started, develop a daily routine that is comfortable and meets your needs. For those already diagnosed with spinal stenosis, work with your doctor or physical therapist to create a safe exercise strategy that will help you build endurance and maintain flexibility.
Remember to Stretch
In addition to exercise, stretching is another excellent way to keep your spine healthy and improve your range of motion. Stretching has also proven to be an effective way to prevent the progression of spinal stenosis. Ask your doctor or physical therapist for suggestions that will be effective in promoting spine health or relieving symptoms you may be experiencing.
Think About Posture
From working at your desk to lifting heavy objects or bending, maintaining good posture will keep your spine healthy and prevent wear and tear that could lead to spinal stenosis. There are many informative resources online that can help you improve your posture, including this guide from the National Library of Medicine.
Maintain a Healthy Weight
Keeping a healthy weight is crucial when it comes to spine health and avoiding complications from spinal stenosis. Excess weight puts a lot of additional pressure on the spine, strains muscles and ligaments, and can lead to serious health conditions such as heart disease, diabetes, and cancer. Extra body weight also impacts factors like strength and flexibility, which you will need for exercise and maintaining good spine health.
If you are experiencing pain, numbness, or weakness in the lower back, arms, feet, or butocks, you may have spinal stenosis. Fortunately, there are many effective options to manage symptoms and keep your spine healthy. For more information about spinal stenosis, or to schedule an appointment at Insight Neurosurgery, contact us at (810) 275-9333.