Spinal Stenosis

Spinal stenosis is a term used to describe narrowing of the bony canal surrounding either the spinal cord or the opening through which the spinal nerve exits the spine.  Narrowing within the spinal canal is referred to as central stenosis while narrowing of the opening through which the spinal nerve exits is called lateral stenosis.  In either case, spinal stenosis is a consequence of the degenerative changes that take place within the spine as a natural course of aging.

Causes
Spinal stenosis can be the result of congenital (being born with it) or developmental factors.  In some cases, both factors play a role in the process.  Some of the developmental factors include:

• Spinal fracture
• Degenerative changes in the spine
• Scar tissue formation following surgery
• Spinal instability
• Disc herniation

Symptoms
The symptoms associated with spinal stenosis include pain in one or both legs.  In addition, complaints of leg numbness or pins and needles sensations are encountered.  The patient will typically report of an ease of symptoms with bending forward and an increase in symptoms with standing or reaching overhead.  Finally, the patient may report of a general sense of weakness or reports tiring easily.

Diagnosis
Typically, the patient’s description of symptoms in conjunction with the findings of the physical examination is enough to raise the examiner’s index of suspicion for the presence of stenosis.  Confirmation of the diagnosis is made with the use of x-rays, MRI and/or CT scans, or the use of EMG testing to assess the integrity of the nerves.

Treatment
Nonsurgical Treatment
The nonsurgical management of spinal stenosis is beneficial in about 50% of the patients reporting of mild to moderate symptoms.  The typical course of nonsurgical treatment will include the use of medications to reduce inflammation, decrease pain, and reduce any muscle spasm.  Sometimes anti-depressants/anti-anxiety medications will also be used.

Following medication management, physical therapy may also be incorporated into the treatment regimen.  The goals of physical therapy to treat spinal stenosis include the reduction of symptoms, restoration of functional movement, and patient education on how to best manage the condition on your own.  Spinal decompression therapy or traction is often recommended and may be beneficial in alleviating symptoms by taking pressure off the spinal nerves.  Specific strengthening and endurance exercises are often prescribed at this stage to maintain spinal health and build tolerance to daily activities.  Here’s a simple exercise that will often take stress off the spine ===> Treatment for Spinal Stenosis

For my patients suffering with spinal stenosis, I will incorporate a specially designed back support into their treatment regimen.  The back support provides two critical roles: 1.) Provides external support to the spine allowing the patient to stay active/ and 2.) Provides an “unloading” component to the spinal elements that assists in taking pressure off irritated spinal nerves.  Read more about back braces here ===> Back Supports

If a patient’s symptoms are severe enough and don’t respond to conservative care, epidural steroid injections may be considered.  The purpose of these injections are to reduce swelling and inflammation of the spinal nerves, giving the nerves more room inside the spinal canal.  Read more about epidural steroid injections here ===> Epidural Steroid Injections

Surgery
Patients suffering with severe symptoms of spinal stenosis may require surgery.  The choice of the type of spinal surgery will be dependent on several factors including the age of the patient, the general health of the patient, and the severity of the condition.  For the most part, decompressive procedures, such as laminectomy, are considered first.  Spinal fusion tends to be much more involved and is considered if instability is present.  For a more in depth review of the surgical procedures used to treat spinal stenosis, go here ===> Back Surgery

If you’ve been diagnosed with spinal stenosis and would like some professional advise on what to do about it, you can arrange for a free phone consultation here === > Free Phone Consultation

Written by Malton A. Schexneider, PT, MMSc