Do your legs or back feel better when you are leaning over a shopping cart when walking? If so, you might have Spinal Stenosis.

What is Spinal Stenosis? 

Spinal Stenosis is a narrowing of areas in the lumbar (back) or cervical (neck) spine that causes pressure on the spinal cord or one of more of the spinal nerves.

Who Gets Spinal Stenosis?

Spinal Stenosis is most common in men and women over 50 years of age. However, it may occur in younger people who are born with a narrowing of the spinal canal or who suffer an injury to the spine.

What Causes Spinal Stenosis?

Narrowing of the spinal canal leads to spinal stenosis. It can result from congenital conditions or be acquired.
When people are born with a small spinal canal, it is a condition called congenital spinal stenosis. Sometimes people have a curvature of the spine known as scoliosis, which can put pressure on nerves. Either of these conditions can lead to spinal stenosis.

Acquired conditions can also cause spinal stenosis. The most common cause of spinal stenosis results from a degenerative process that is part of aging.   As you age, your spinal structures change. Ligaments may thicken; bones and joints may also enlarge due to wear and tear over time, and spinal stenosis can occur.

When one vertebrae slips forward on the one below it, a condition called Spondylolisthesis results. This slippage can also result in spinal stenosis.

Spinal Stenosis can also occur due to tumors in the spine.

Any of these processes can cause narrowing of the spinal canal resulting in spinal stenosis.
  
What are the Symptoms of Spinal Stenosis?

Narrowing of the spinal canal can cause a number of symptoms. 

People often experience numbness, weakness, tingling, cramping, or pain in the back, buttocks, thighs, and calves or in the neck, shoulders or arms.

Symptoms from spinal stenosis are more likely to be present or get worse when you stand or walk upright. However, symptoms often disappear or lessen with sitting or flexing the lower back.  

You may notice that you feel better when you walk with a grocery cart; this is because the back is placed in a flexed position.

With more severe stenosis, people may have problems with bowel and bladder function and weakness of the foot.

Cauda equina syndrome is a very severe and rare condition. It is caused by severe narrowing of the spinal canal that compresses the nerve roots below the level of the spinal cord. With cauda equina syndrome, symptoms can include loss of control of the bowel and bladder functions and lower extremity weakness with loss of feeling in one or both legs. One may also experience numbness in the groin or area of contact if sitting on a saddle. Cauda equine syndrome is considered a surgical emergency.

How is Spinal Stenosis Diagnosed? 

The diagnosis begins with a thorough medical history, and physical examination. Diagnostic testing including, x-rays, MRI and/or CT Scans can be done to identify the source of pain.

What are Treatment Options for Spinal Stenosis?
 
Non-Surgical options are usually prescribed for treatment of spinal stenosis unless the person has severe or progressive nerve damage. 
 
Medications such as non-steroidal anti-inflammatory drugs like Ibuprofen and Naproxen can be prescribed to reduce pain and inflammation.
 
Epidural steroid Injections can be prescribed for pain relief. These injections are also a very good option for those who are unable to undergo surgery due to other medical problems. 
 
Physical therapy can be a viable option to help to maintain the motion of the spine, strengthen abdominal and back muscles. Aquatic or water therapy is also an excellent option for persons with spinal stenosis.
 
When Should Surgery Be Done?

Nonsurgical treatment is done initially to determine if it helps reduce the symptoms from spinal stenosis. However, surgery might be performed immediately when a patient has leg weakness and impaired bowel or bladder function. The effectiveness of nonsurgical treatments and the severity of the patient's pain will all play a part in determining whether or not to have spinal surgery.

The goal of surgery is to relieve pressure on the spinal cord or nerves and to restore and maintain alignment and strength of the spine.

Consult your physician if you have symptoms of Spinal Stenosis.

©2012 Winifred D.Bragg, MD. All Rights Reserved.