SPINAL STENOSIS

SPINAL STENOSIS

Spinal stenosis is the reduction of available space within the spine, which leads to increased pressure on the spinal cord and the nerves that exit the spine to the arms and legs.

Spinal stenosis occurs mostly in the lower back and neck, and is usually caused by gradual wear-and-tear related to osteoarthritis.

For some people, spinal stenosis causes no symptoms. Others feel pain, numbness, weakness, and bladder or bowel function problems. Treatment options depend on the severity of the stenosis and include medication, physical therapy and surgery.

Symptoms

Even if you have spinal stenosis you might not exhibit any symptoms if the pressure on the spinal cord and nerves is not great enough to cause any problems. In cases where symptoms are felt, they usually start off gradually and slowly get worse. Possible symptoms vary and depend on the exact location of the stenosis.

Cervical stenosis, or stenosis in the neck, usually causes tingling in the hand. Many people also have problems balancing and walking. Other possible symptoms include pain, numbness, weakness, and tingling in an arm, leg, or foot.

Lumbar stenosis, or stenosis in the lower back, usually causes pain or cramping in the legs after walking or standing for a long time. This discomfort normally eases if you bend forward or sit down. Nerves to the bladder or bowel may also be affected, leading to incontinence.

Causes

While some spinal stenosis cases are genetic, most occur due to other factors such as bone overgrowth, herniated discs, thickened ligaments, tumors or spinal injuries.

Bone overgrowth occurs when wear and tear damage from osteoarthritis on spinal bones triggers the growth of bone spurs, which can protrude into the spinal canal. Paget’s disease can also cause bone overgrowth in the spine.

A herniated disc occurs when one of the discs in the spine ruptures or slips out of place. The discs are tough exterior encasings around softer gel-like centers and act as rubbery cushions between each of the bones (vertebrae) of the spine. When a disc is herniated, it is either out of place or the soft center is pushing out through a crack in the tough exterior, creating excess pressure on the spinal cord or nerves.

The ligaments of the spine hold the spine bones together. With age they can become stiff and thickened, bulging into the spinal canal.

In some cases, a tumor or abnormal growth presses against the spinal cord or nerves as it grows adjacent to within the spinal cord

Diagnosis

Spinal stenosis is difficult to diagnose because its symptoms can easily be mistaken for other age-related conditions. Imaging tests are usually necessary to pinpoint the exact cause of the symptoms. Imaging tests may include X-rays, MRIs, and CT myelograms.

Treatment

The course of treatment for spinal stenosis depends on the location of the stenosis and the severity of the symptoms.

Commonly used medications include:

  •       Nonsteroidal anti-inflammatory drug (NSAIDs) to relieve pain and reduce inflammation
  •       Muscle relaxants to calm any muscle spasms that are common with spinal stenosis
  •       Antidepressants to help ease chronic pain
  •       Anti-seizure drugs to reduce pain caused by any damaged nerves
  •       Opioids to relieve pain

Physical therapy is commonly prescribed to strengthen the spine, improve balance, and increase stamina, flexibility and stability of the spine.

If there is a swollen nerve roots at the area of the stenosis, a corticosteroid injection can help reduce the inflammation in some cases. Steroid injections are not effective for everyone and are not given more than a few times a year because repeated steroid injections can weaken adjacent bones and connective tissue.

Surgery

If conservative treatments are not effective or if your symptoms hinder your daily activities, you should consider a surgical procedure to create more space within the spinal canal and relieve pressure on your spinal cord or nerve roots. With any surgery there is the possibility of complications or recurrence of symptoms, but in most cases, surgery successfully reduces spinal stenosis symptoms.

If you are suffering from pain that may be due to spinal stenosis, contact us immediately for a consultation.

Dr. Root and Dr. Villanueva are physicians based in Burbank, CA, and are focused on the multi-disciplinary approach of treating pain. They approach each case from a variety of disease processes including neck and back spinal conditions, complex regional pain syndrome, joint disease, and chronic pain from spinal cord injuries, neurological disorders, cancer, and other medical conditions. Call us at 818-875-5501 so we can create a comprehensive treatment plan to restore you back to full health.

 

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