Spinal stenosis is the narrowing of spaces in the spine (backbone) which causes pressure on the spinal cord and/or nerves. About 75% of cases of spinal stenosis occur in the low back (lumbar spine). In most cases, the narrowing of the spine associated with stenosis compresses the nerve root, which can cause pain along the back of the leg.
What Causes Spinal stenosis?
Spinal stenosis has many potential causes; including
In the normal aging process, the body’s ligaments (the connective tissues between the bones in the spine) can thicken. Spurs may develop on the bones and into the spinal canal. The cushioning disks between the vertebrae may begin to deteriorate. The facet joints (flat surfaces on each vertebra that form the spinal column) also may begin to break down.
Osteoarthritis and rheumatoid arthritis are two forms of arthritis that may especially affect the spine.
Structural deformities of the involved vertebrae due to heredity can cause narrowing of the spinal canal.
Instability of the spine (spondylolisthesis) is caused when one vertebra slips forward on another and which, in turn, causes narrowing of the spinal canal.
Abnormal growths (tumors of the spine) of soft tissue may affect the spinal canal directly by causing inflammation or by growth of tissue into the canal. Tissue growth may lead to bone resorption (bone loss due to over-activity of certain bone cells) or displacement of bone and the eventual collapse of the supporting framework of the spinal column.
Accidents and injuries (trauma) may either dislocate the spine and the spinal canal or cause burst fractures that produce fragments of bone that penetrate the canal.
What Are the Symptoms of Spinal stenosis?
Stenosis may pinch the nerves that control muscle power and sensation in the legs, resulting in low back pain as well as pain in the legs. Additional symptoms may include pain when walking, numbness tingling, hot or cold feelings in the legs, unsteadiness and clumsiness, and even frequent falling.
How Is Spinal Stenosis Diagnosed?
Spinal stenosis can be difficult to diagnose because its symptoms can be caused by other conditions. Usually, people who develop stenosis have no history of back problems or any recent injury. Often, unusual leg symptoms are a clue to the presence of spinal stenosis.
If simple treatments, such as postural changes or non-steroidal anti-inflammatory drugs, do not relieve the problem, special imaging studies may be needed to determine the cause of the problem. An MRI (magnetic resonance image) or CAT scan (computed tomography) may be requested. A myelogram (an X-ray taken after a dye is injected into the spine) may be performed. These and other imaging studies can offer details about the bones and tissues and help with diagnosis.
How Is Spinal stenosis treated?
Spinal stenosis can be treated several ways that may provide temporary relief. For example, changing posture by leaning forward while walking or lying with knees drawn up to the chest, taking non-steroidal anti-inflammatory medications, resting more, or engaging in non-impact aerobic activity such as bicycling may help relieve symptoms. At some point, surgery may be recommended. But here too, as with treating other back and neck problems, for the majority of patients, surgery should be the last option.
This is precisely the point at which patients – who desperately need longer lasting relief but for whom medication has not helped, and who are unconvinced by and fear surgery – should consider undergoing a thorough chiropractic examination and treatment.