Is Spinal Stenosis causing my neck or back pain?
Is Spinal Stenosis causing my neck or back pain?
Spinal Stenosis Overview
Spinal stenosis is a generic term that is used to describe a group of spinal conditions. These conditions involve a narrowing, or constricting, of various structural components of the spinal column. This narrowing can lead to bone-on-bone contact, compression of the spinal nerves, or even the compression of the spinal cord itself. Compression can lead to inflammation, pain, problematic mobility, and difficulty participating in one’s everyday activities.
There are many different locations on the spinal column, as well as several spinal structures, in which stenosis can occur. Stenosis can appear in the cervical (neck), thoracic (rib cage), and lumbar (lower back) segments of the spine, with a majority of cases being reported in the lumbar spine. Additionally, different types of stenosis are identified by the structure of the spine in which the narrowing occurs. These types include: central stenosis, foraminal stenosis, and far lateral stenosis.
Central stenosis is a narrowing of the central spinal canal in which the spinal cord runs. This constriction can lead to pressure on, as well as inflammation of, the spinal cord itself and results in a variety of troubling symptoms.
Foraminal stenosis involves the narrowing of the foramina in the spine. The foramina are openings in the vertebrae that allow for nerve roots to branch out from the spinal cord and to extend to other parts of the body. When the foramina become smaller as a result of foraminal stenosis, spinal nerves often become compressed. This pinching of nerve tissue can lead to any of the painful, even debilitating, symptoms of spinal stenosis.
Far lateral stenosis involves narrowing near the facet joints. These joints, located on the back side of our vertebrae, connect one vertebra to another and help with the many movements of our spine. Our spinal root nerves branch off from our spinal cord, pass through the foramina, and then travel on through the facet joints. When these joints become compromised by age, injury, or other factors, compression of nerves can occur and pain can ensue.
Symptoms of Spinal Stenosis
As with many spinal conditions, the symptoms of spinal stenosis can seem very similar to other possible diagnoses. Additionally, symptoms can vary greatly from person-to-person, especially because stenosis can occur in different areas and structures of the spine. In order to accurately reach a diagnosis, it is important to consult a physician who can use all the tools in their toolbox to fully assess the source of your pain and discomfort. That being said, if you are experiencing any of the symptoms listed below, you may be dealing with spinal stenosis, and should address this possibility with the assistance of a professional. Symptoms may include:
- Localized pain, ranging from dulling or aching to sharp and stabbing
- Radiating pain that shoots through the arms or legs
- Muscular weakness in arms or legs, which can affect one’s ability to perform actions steadily
- Slow onset of symptoms that can take up to several years to develop to their full severity
- Possible loss of bowel or bladder control. Seek immediate medical attention if this occurs.
If you think you are experiencing any symptoms associated with spinal stenosis, please contact the Advanced Spine Center today. Dr. Jason E. Lowenstein is fully versed in minimally invasive treatments for spinal stenosis, and adopts an individualized, patient-centered approach to designing treatment plans. Dr. Lowenstein is here to help you find relief from your pain and discomfort, and will get you back to participating in your daily life
Causes of Spinal Stenosis
Just as there are many symptoms of spinal stenosis, there are nearly as many, if not more, causes of the condition. Most cases, however, are reported to occur due to age and degeneration of the spine over years of activity and use. We use our backs in practically all of our daily activities; walking, lifting, twisting, sitting up, and laying down. This frequent use, coupled with the aging and drying out of our tissues and intervertebral discs as well as degeneration of our spinal structures, can wear down the spine, causing spinal components to move closer together. Conditions associated with older age, such as osteoarthritis or rheumatoid arthritis, can also accelerate this degeneration as well.
Chronic strain on the back is another major cause of spinal stenosis. Although we all use our back every day, some individuals use it even more strenuously, especially those who work at labor intensive jobs such as nursing, construction, or athletics. These individuals place chronic strain on their spine, which can accelerate spinal degeneration and stenosis.
Other causes of stenosis can include: spinal tumors, herniated discs, thickened ligaments, and overgrown bones (or bone spurs).
Spinal Stenosis Treatment Options
Pain management is almost always a component of dealing with back pain. Oral pain medications, whether over-the-counter or prescription strength, can help many deal with pain and inflammation. Corticosteroids, epidural injections, and steroidal injections can also be used.
If one is dealing with foraminal stenosis, then a foraminotomy may be required. This minimally invasive surgical procedure targets the narrowed foramina, and involves removal of bony material to increase the size of the foramina. This can relieve pressure and reduce pain.
The lamina is a thin bony layer on the vertebrae that covers the posterior surface of the spinal cord. Often with central stenosis, removal of this structure is needed to decompress the spinal cord. A laminotomy removes a portion, whereas a laminectomy removes the whole.
A spinal fusion is a surgical procedure that restores stability to the spine. With conditions such as spinal stenosis, herniated or bony tissues are often removed from the spine to release pressure. It then becomes necessary to reinforce the spine through mechanical fusion.