The spine is made up of vertebrae, nerves, and discs. Inside the spine, there is a hole where the spinal cord travels through. This is the spinal canal. There are also some other holes where the nerves can connect to the spinal cord, which are located at the joints of the vertebrae. These are called foramina or the foramen. When the spinal canal and foramina shrink or become more narrow through various means, this is known as spinal stenosis. Spinal stenosis can cause nerve issues and nerve damage, resulting in several severe problems. Most people who experience spinal stenosis are over the age of fifty, but several people can have it at a younger age due to birth defects or other issues.
Causes of Spinal Stenosis
As we age, our bodies go through changes. Sometimes spinal stenosis can be caused by the spinal canal just being too small to begin with, or through injury, but most people contract it as a result of aging.
One of the main causes of spinal stenosis is arthritis. Arthritis causes the protective cartilage around our bones to deteriorate, which in the spine causes the bones to rub together. When bones rub together, it can cause things called bone spurs to develop. A bone spur can be large or small. If a bone spur develops inside the foramen or the spinal canal, it will compress those nerves and be very painful.
Degenerative Disc Disease
Another issue that can create spinal stenosis is degenerating discs. The discs between your vertebrae can shrink, tear, or herniate as you age. If a disc herniates, it can push into the spinal canal and compress the nerves. If it shrinks, basically losing its fluid, it can create less space in the foramina, crushing those nerves as well.
Tumors and cysts can occur at any age, and these can press into the spinal canal or foramen. These may shrink or grow over time. While possible, these are less common causes of spinal stenosis.
Another result of aging is that the ligaments that surround your spine can become tough and rigid. These can bulge into the spinal canal, or if they rip or tear they can create problems in your alignment, also crushing those nerves.
Spinal Stenosis and Walking Problems
The symptoms of spinal stenosis usually consist of pain, numbness or tingling, and a lack of mobility. Unfortunately, lumbar spinal stenosis can cause problems walking. This is because the nerves that connect to the legs are compressed and painful. If spinal stenosis is left untreated, lumbar spinal stenosis can lead to becoming unable to walk. Complete paralysis is very rare but it can happen. At this level, incontinence and bowel dysfunction can also occur. If the spinal stenosis can be treated, this may be resolved and the patient may be able to walk again.
Treatment for Spinal Stenosis
One of the more overreaching treatments for spinal stenosis is medications. Pain medications are definitely a part of this, but there are some other medications that can help. A common medication that is prescribed for stenosis is actually some anti-seizure drugs, which can block nerve pain from damaged nerves. Some doctors may also prescribe antidepressants to help with chronic pain. Pain management can be difficult, so be sure to work with your doctor.
Orthopedic physical therapy can be an option for certain kinds of spinal stenosis. Physical therapy is an amazing treatment, and it can strengthen the surrounding muscles, helping them to not compress so much on the nerves. It can be a painful process, but it can relieve pain as well.
Sometimes, spinal stenosis pain can be relieved through chiropractic care. Realignment of the spine can help the patient experience some pain relief without the use of medications. It is particularly helpful for people with herniated or diseased discs.
Some people benefit from steroid injections, where a doctor injects medication directly into the affected area. These can help with inflammation and pain in the nerves, and it can relieve pain for up to a year. This can help many people begin physical therapy or even help them return to everyday activities.
The most effective treatment for spinal stenosis is usually surgery, because sometimes it is the only option to really relieve the pain. Some spinal stenosis cannot be treated through surgery if it is too severe or if there are too many risks to consider. At that point, the patient can only manage their symptoms instead of relieving them. Surgery can be very effective for the removal of bone spurs, especially in certain areas. It can also be effective in removing or replacing damaged and diseased discs. There are also some surgeries that remove the bone surrounding the foramen or some of the spinal column. These can help relieve the pressure and basically repair a patient’s stenosis. This does not mean it will be permanent, but it can definitely help with the pain and symptoms of nerve problems. If any nerve damage was done, surgery cannot repair that. Many surgeons are able to perform these surgeries in a minimally invasive manner, which might also save recovery time and reduce the risks.
What should I do if I feel I have Spinal Stenosis?
The first thing you should do if you are experiencing symptoms consistent with spinal stenosis is make an appointment with your doctor. They will suggest treatment, help with your pain, and try to identify the problem as quickly as they are able. Nerve damage is very possible if you do have spinal stenosis, so you will need to get treatment as soon as you can. A doctor can do several tests and use tools like x-rays and CT scans to determine what is wrong, and can go about making sure you get the best possible care. You may not need to live with your pain! Make an appointment with your doctor today so that you can start on a treatment plan and help your body heal.