Spinal Stenosis – Treatments, Cure, Causes

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Spinal Stenosis

In people with spinal stenosis, the spine is narrowed in one or more of three parts:

The space at the center of the spine
The canals where nerves branch out from the spine
The space between vertebrae (the bones of the spine).

This narrowing puts pressure on the spinal cord and nerves and can cause pain.

Spinal stenosis is most common in men and women over 50 years old. Younger people who were born with a narrow spinal canal or who hurt their spines may also get spinal stenosis.

Aging

Changes that occur in the spine as people get older are the most common cause of spinal stenosis. As people get older:

The bands of tissue that support the spine may get thick and hard
Bones and joints may get bigger
Surfaces of the bones may bulge out (these are called bone spurs)

Arthritis

In some cases arthritis, a degenerative (gets worse over time) condition can cause spinal stenosis. Two forms of arthritis may affect the spine: osteoarthritis and rheumatoid arthritis. Osteoarthritis:

The most common form of arthritis
Most often occurs in middle-aged and older people
Doesn’t go away
May involve many joints in the body
Wears away the tough tissue (cartilage) that keeps the joints in place
Causes bone spurs and problems with joints.

Rheumatoid Arthritis

Affects most people at a younger age than osteoarthritis
Causes the soft tissues of the joints to swell and can affect the internal organs and systems
Is not a common cause of spinal stenosis
Can cause severe damage, especially to joints
Inherited Conditions

Some people are born with conditions that cause spinal stenosis. For instance, some people are born with a small spinal canal. Others are born with a curved spine (scoliosis).

Other Causes

Other causes of spinal stenosis are:

Tumors of the spine
Injuries
Paget’s disease (a disease that affects the bones)
Too much fluoride in the body
Calcium deposits on the ligaments that run along the spine

What Are the Symptoms of Spinal Stenosis?

There may be no symptoms of spinal stenosis, or symptoms may appear slowly and get worse over time. Signs of spinal stenosis include:

Pain in the neck or back
Numbness, weakness, cramping, or pain in the arms or legs
Pain going down the leg
Foot problems.

One type of spinal stenosis, cauda equine syndrome, is very serious. This type occurs when there is pressure on nerves in the lower back. Symptoms may include:

Loss of control of the bowel or bladder
Problems having sex
Pain, weakness, or loss of feeling in one or both legs

How Is Spinal Stenosis Diagnosed?

To diagnose spinal stenosis, your doctor will ask about your medical history and conduct a physical exam. Your doctor may also order one or more tests, such as:

X rays
Magnetic resonance imaging (MRI) – a test that uses radio waves to look at your spine
Computerized axial tomography (CAT) – a series of x rays that give your doctor a detailed image of your spine
Myelogram – a test in which the doctor injects liquid dye into your spinal column
Bone scan – a test in which you are given a shot of radioactive substance that shows where bone is breaking down or being formed

Who Treats Spinal Stenosis?

Based on your symptoms, your doctor may refer you to:

Rheumatologists (doctors who treat arthritis and related disorders)
Neurologists and neurosurgeons (doctors who treat diseases of the nervous system)
Orthopedic surgeons (doctors who treat problems with the bones, joints, and ligaments)
Physical therapists

What Are Some Nonsurgical Treatments for Spinal Stenosis?

There are many nonsurgical treatments for spinal stenosis. Your doctor may prescribe:

Medicines to reduce swelling
Medicines to relieve pain
Limits on your activity
Exercises and/or physical therapy
A brace for your lower back

When Should Surgery Be Considered?

Your doctor will likely suggest nonsurgical treatment first unless you have:

Symptoms that get in the way of walking
Problems with bowel or bladder function
Problems with your nervous system.

Your doctor will take many factors into account in deciding if surgery is right for you. These include:

The success of nonsurgical treatments
The extent of the pain
Your preferences.

What Are Some Alternative Treatments for Spinal Stenosis?

Alternative treatments are those that are not part of standard treatment. For spinal stenosis, such treatments include chiropractic treatment and acupuncture. More research is needed on the value of these treatments. Your doctor may suggest alternative treatments in addition to standard treatments.

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