Texas Pain Network

Texas Pain Network

Spinal Stenosis

Spinal Stenosis

Medically speaking, the term stenosis refers to any abnormal narrowing of any particular body channel. Here, specifically, we are talking about the spine.

Causes

Symptoms

Spinal Stenosis: Abnormal Narrowing of the Spinal Cord

Medically speaking, the term stenosis refers to any abnormal narrowing of any particular body channel. Here, specifically, we are talking about the spine.


So why can it be so painful to lose a little bit of space? To understand this, you first must understand the anatomy of the spine. Made up of seven vertebrae, eight nerve roots and 32 muscles – in addition to discs, joints, ligaments and the actual spinal cord, your spine is truly a complex structural masterpiece.


The spinal cord provides a path for the nerves to pass from the brain to the rest of the body. They are protected by a vertebral column running from the sacrum up to the neck and skull. And each vertebra comes with a bony attachment that serves to help stabilize the spine and adds another layer of protection to the spinal cord.


There is also a large central canal housed within the vertebral column through which the spinal cord passes. Neuroforamen (tiny holes) then appear on each side of the canal, enabling the spinal nerves to escape and maneuver as necessary.


Typically just a symptom of age, spinal stenosis occurs when bony growths in the spine narrow the central canal, constricting the spinal cord and associated nerves. Deterioration of the facet joints in the back of the spine can also play a contributing factor – as well as injury or structural deformity (as in scoliosis).

There are two types of spinal stenosis and both exhibit different symptoms:

  • Lumbar stenosis: occurring in the lower back, symptoms often include tingling, weakness or numbness in the lower back and legs and leg pain when walking.
  • Cervical stenosis: occurring in the neck, symptoms often include pain, weakness or numbness in the shoulders, arms and legs, neck pain and burning sensations, pins and needles and tingling in the impacted extremity.

Once a diagnosis has been confirmed, there are surgical and non-surgical options available for both conditions:

  • Exercise: swimming, Tai Chi and bicycling are often recommended as natural treatment modalities (especially for lumbar stenosis). The goal is to stay as active as comfortable so as not to be further debilitated by inactivity.
  • Activity modifications: avoiding any activities that aggravate the injury are paramount. This often includes running and most contact sports. However, more simple modifications are helpful too like sitting in a recliner as opposed to a hardback chair and leaning forward on the bike, walker or shopping cart to maximize comfort.
  • Injections: epidural cortisone injections are often used to relieve symptoms and help restore quality of life, though repeated use is not recommended for some patients prone to osteoporosis-related fractures.
  • Medications: anti-inflammatory medications can help manage the symptoms associated with the condition, while narcotics can be administered mindfully for nerve pain. Anti-depressants are also prescribed, as well as nerve desensitizing medications and muscle relaxants. 

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