The word “stenosis” means that a channel within the body is narrowing. In regards to the spine, it means that there is a bone channel that is narrowing, which affects the nerves in the spine. While some people are born with a congenital form of spinal stenosis, some people develop it over time. Sometimes the effects aren’t felt, but it’s a slow process. Once nerves start being compressed, numbness can occur.
Cervical and Lumbar Stenosis
The neck can develop cervical stenosis, and the lower back can develop lumbar stenosis. Cervical stenosis can lead to serious weakness and even paralysis. This is due to cord compression. If cord compression is serious, surgery may be needed.
In the case of lumbar stenosis, tingling or weakness may be felt into the buttocks and legs, especially when active. When a person first describes symptoms, it can sound a lot like vascular insufficiency because of the pain that occurs when walking. If vascular studies show blood flow is normal, then testing will be done to confirm spinal stenosis. Sitting usually relieves the pain, and so will being flexed forward while walking.
Thoracic stenosis is possible, but it’s not as common. The thoracic section of the spine is the middle and upper portion. It is the area where the vertebrae connect to the ribcage. Because movement of this part of the spine is limited, degenerative conditions aren’t likely to develop.
Symptoms of Spinal Stenosis
There are a number of symptoms to be aware of. This is a slow onset condition, so the pain can come and go. When it does, the following may occur:
- The pain may occur during activities, such as walking or biking.
- Standing upright may be painful.
- Rest relieves the pain or when standing with the upper body in a forward leaning position.
- Lumbar stenosis may result in leg pain that goes away with rest.
Treatment for Spinal Stenosis
Certain exercises work well for treating spinal stenosis. Supervised physical therapy is a good gateway for people to transition to their own exercise program. In other cases, activity may be modified. Patients experiencing spinal stenosis tend to be counseled on avoiding activities that cause them pain or worsens the condition. Recommended activity modification resembles something like instructing a patient to lean forward against the handle of a shopping cart at the grocery store.
Epidural injections have also proven to be effective. Pain is temporarily relieved, but there is concern about the long-term use of these injections. If medication, such as anti-inflammatory medications, is effective, it will be recommended. Narcotics tend to be prescribed for the short term to avoid addiction. Muscle relaxers may also be prescribed to relax the muscles around the spine. In cases where the nerves need to be desensitized, there are medications that will do this, but they aren’t prescribed unless it is absolutely necessary. Sometimes antidepressants can produce pain relief. The only reservation about medication is that there may be side effects, which is why it is important to make your doctor and pharmacist aware of all medications you are taking.
