Spinal stenosis is the unusual narrowing of the spinal canal that causes pressure on the nerve roots and/or spinal canal. It primarily affects areas in the spinal cord.
A person affected with spinal stenosis may experience symptoms such as numbness, pain, or tingling in the back or neck area. There are also instances when people that have spinal stenosis may not have symptoms at all but may appear if certain triggers happen.
Spinal Stenosis Overview
When the disorder develops in the neck part, it’s called cervical stenosis. On the other hand, if the disorder develops in the lower back, it’s called lumbar stenosis.
Symptoms are progressive and may worsen if not given proper medical attention immediately. In severe cases, individuals may also experience sexual dysfunction and loss of bowel and bladder control.
Traditional treatments may involve medications that reduce pain and inflammation. In serious cases, it may even include spine surgeries. We may also manage symptoms through exercise/stretching, icing the affected area, or physical therapy.
In 1803, a French doctor named Antoine Portal published the very first descriptions of Spinal Stenosis symptoms. However, researches find descriptions of this disorder that dates back to the ancient Greeks and Egyptians
Types of Spinal Stenosis
It can affect any regions of the spine. Its classification may depend on what area the disorder developed. If symptoms occur in the cervical vertebrae or neck area, it’s referred to as cervical spinal stenosis. The symptoms in the lumbar or back area are called lumbar spinal stenosis. While the symptoms in the thoracic or mid-back are called thoracic spinal stenosis.
Lumbar spinal stenosis
It compresses spine nerve roots in the lower back that causes pain and numbness in the back area through the buttocks and upper legs. These symptoms also referred to as sciatica. It may also hinder blood flow that leads to a condition called neurogenic claudication.
Cervical spinal stenosis
It compresses the spinal nerves in the neck. It’s commonly caused by chronic degeneration. Other causes may include spine trauma or genetics. The pressure against the spinal cord may lead to a more serious condition called myelopathy, which causes weakness and even paralysis. Hence, it’s considered to be the riskiest condition among spinal stenosis types.
Thoracic spinal stenosis
It’s a rare type of spinal stenosis which usually affects the mid-back. It’s uncommon because the rib cage maintains its stability and gives the middle back limited movement.
Causes and Risks Factors
According to studies, spinal stenosis affects approximately 8% of the general population worldwide. It involves the wear-and-tear of the spinal cord that is most common to the elderly, which is fifty years in above. We may also find them in younger individuals with arthritis or genetic conditions that deteriorate their spine. Researchers observed that most people with spinal stenosis have a medical history of the following; scoliosis, spinal tumors, osteoarthritis, spondylolisthesis, spinal trauma, and Paget’s bone disease. It may also be caused by a genetic abnormality called achondroplasia.
In another study, the woman also appears to be more prone than man. The data showed that one in four women in ages between fifty and eighty may experience spinal stenosis. This is in comparison with one in ten men who are likely to experience spinal stenosis.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases have provided general signs and symptoms of spinal stenosis to look out for. Symptoms may also vary depending on affected areas and health condition of the individual. For example, paralysis and major body weakness may usually occur only on cervical stenosis patients.
Lumbar stenosis symptoms include:
- Numbness in the back area through the buttocks and upper legs
- Weakness in both or one leg and feet
- Back pain that usually starts in the lumbar area down to the upper legs (referred to as sciatica)
- In rare and severe cases, it may cause loss of bladder and/or bowel control
- Also in rare instances, it may cause sexual dysfunction
Cervical spinal stenosis symptoms include:
- Neck pain that usually goes down into both or one arm and hands
- Numbness and weakness experienced through the arms and hands
- In some instances, uncontrollable shaking of the hands
- In rare events, feelings of weakness in the entire body and paralysis (also called myelopathy). Individuals may also experience difficulty in maintaining their balance
- Also, in rare events, patients may experience bladder and bowel problems
Symptoms of thoracic spinal stenosis are the same as lumbar stenosis. The difference is that thoracic stenosis may develop in the mid-back. It also rarely occurs.
The symptoms mentioned may resemble other medical condition. Thus, always consult your doctor if you experience any of these symptoms.
The doctor will normally start by asking medical history and symptoms. If he sees any signs of spinal stenosis, he may perform a physical examination. Then he may order several tests to conclusively diagnose spinal stenosis, it includes:
- Magnetic resonance imaging or simply, MRI scans: It’s the most used instrument to identify spinal stenosis. According to some experts, it’s also more accurate than CT scans or X-rays in determining the exact cause of spinal nerve compression. Results usually reveal complete image structure of the spinal cord which includes the muscles, nerves, and ligaments.
- Electromyogram (EMG scan): this tests checks on the nerve condition in your legs and feet.
- Computed tomography (CT scan): primarily used to check the condition of the spinal canal. It’s also usually the alternative for MRI scans when patients have implanted peacemakers.
- X-ray: this is to check the overall condition of the bone.
Two options are available in treating spinal stenosis—it’s either non-surgical or surgical. However, these two methods may only offer temporary relief. Today, there’s no known cure for spinal stenosis.
Non-surgery treatments include:
- Medications: especially drugs that reduce inflammations and pain like nonsteroidal anti-inflammatory and acetaminophen.
- Physical therapy: its primary purpose is to support self-care. The physical therapists will help us in strength and stretch exercise that may focus on affected areas.
- Exercise: we can do stretching and physical exercise by ourselves but it must be done with proper precautionary measures. It may also be advisable to consult physical therapists to know which physical exercise is suitable for your condition.
- Corticosteroid injections: a substance that is injected in the affected areas and may provide temporary relief for the individual. Injections are usually conducted in the hospital for outpatients.
The doctor may order surgical procedures if medications or other non-surgical treatment no longer works or condition has worsened. The main purpose of the surgery is to remove bony compounds and a thick ligament that overlies in the spinal canal. This procedure should decompress the spinal canal that frees up space for the spinal nerves.