In medical terms, this condition of the spine is known as spinal stenosis. This means that the space surrounding the spinal cord - or the spinal nerves - narrows. This exerts pressure on the spinal cord and/or the nerves. This condition often affects the spine in the lower back or in the neck. A majority of cases of spinal stenosis are seen in the lumbar spine, known as lumbar spinal stenosis, where there is compression on the nerve root. Therefore, the person will experience radiating pain along the back of the leg.
It can also cause cramping or numbness in the legs, back, neck, shoulders, or arms. In some cases there can also be loss of sensation in the extremities. Other than lumbar spinal stenosis, there is another type of stenosis called cervical spinal stenosis, which is commonly seen in patients. In this condition, it is the upper part of the spinal cord which is affected. There are rare cases that have been recorded, where this condition has also caused problems with bladder or bowel function. There are also cases (rare), where spinal stenosis affects the thoracic spine. Those who are aged 50 and above, female, have suffered from spinal trauma or undergone spine surgery, or born with a narrow spinal canal, are more likely to suffer from spinal stenosis.
There are two categories of spinal stenosis, namely congenital and degenerative. Of the two categories, it is degenerative stenosis that is commonly diagnosed in patients. Congenital stenosis is caused due to an abnormal formation of the spine, which results in narrowing of the spinal canal. This condition is normally observed in patients with a short stature. On the other hand, degenerative stenosis is found in older individuals. It is a result of disc degeneration, arthritis, or bone buildup, to name a few.
What Causes Constriction of the Spine?
Narrowing of the spinal canal is normally seen in middle-aged people. The conditions leading to spinal stenosis can be acquired or inherited. Oftentimes, it is caused by osteoarthritis-related bone damage. The spinal canal is spacious and accommodates the spinal cord. Due to degenerative changes in the spine, the spinal column can narrow down.
This is one of the common causes of spinal stenosis. There are arthritic changes which come about and cause nerve compression. The most common changes include bone spurs, calcification of the spinal ligaments, degeneration of the spinal disc, etc. All of them cause narrowing of the spine and in turn, nerve compression.
If the spinal cord was too small at birth, the spine may further narrow at a relatively young age as well. There can be structural deformities of the vertebrae, which can cause narrowing of the spinal canal.
Accidents or injuries may dislocate the spine and the spinal canal or cause fractures, due to which fragments of bone penetrate the spinal canal. This may eventually lead to spine-related problems.
Abnormal growth of soft tissue may impact the spinal canal causing inflammation, where the growth could occur in the spinal canal itself. The growth of tissue causes bone loss or displacement of the bone. It further leads to collapse of the supporting framework of the spinal column.
Due to aging, the tough connecting tissues between the bones in the spine, thicken. There can also be bone spurs or growth in the spinal canal. Age may also cause the cushioning between the vertebrae, to deteriorate. All these factors cause spinal stenosis.
Both rheumatoid arthritis and osteoarthritis can cause spinal stenosis.
Paget Disease of the Bone
Bone is a living tissue, which is continuously in the process of renewal. Due to Paget disease, the body generates new bone at a faster rate than normal. This leads to soft and weak bones, which are prone to fractures. It may also create bones that may be deformed or abnormally large.
Instability of the Spine:
If a vertebra slips and moves closer to another vertebra, it can cause the spine to narrow.
What Are the Spinal Stenosis Symptoms?
As a matter of fact, when the spinal canal narrows, there will be no visible symptoms experienced. When the condition causes inflammation, then do the symptoms start to show. The most common of the symptoms observed due to constriction of the spine are:
- Pain in the part of the spine that is affected.
- Numbness in the legs.
- Difficulty and pain while walking or standing for an extended period.
- Pins-and-needles sensation observed in the arms or legs, depending on the part of the spine affected by spinal stenosis.
- Frequent falling either while walking or standing.
- Tingling sensation accompanied by hot or cold feeling in the legs.
- Tingling sensation may also be felt in the hands.
- In severe cases of cervical spinal stenosis, the person may lose control over his/her bladder release, which in turn leads to incontinence.
- It may be noticed, that the person is clumsy and may often drop things once held.
- Feeling either a hot or cold sensation in the hands or feet.
Diagnosing Spinal Stenosis
It is commonly seen that a person suffering from spinal stenosis, does not display back pain, or pain in the legs or arms initially. Only when the condition aggravates, are the symptoms displayed. If the condition does not get cured with non-steroidal anti-inflammatory medicines (use under extreme caution; symptoms displayed range from mild to severe), further tests are carried out to assess the condition. Depending on the symptoms displayed, an MRI or CAT scan may be performed on the patient. In some cases, a particular dye is injected into the spine, which is then followed up with an X-ray. These tests help in identifying the problematic tissues and bones in the spine.
Treatment Options Available
This is the initial line of treatment in treating spinal stenosis. Physical therapy emphasizes strengthening the back muscles, along with stretching them to improve posture. Physical therapy also helps in toning the muscles, which further helps in alleviating the condition. When the spine is better supported, the symptoms of nerve compression show changes.
Non-steroidal Anti-Inflammatory Medicines
For pain relief, non-steroidal anti-inflammatory medications (NSAIDs) are prescribed. These medicines reduce inflammation and thereby relieve some pressure that is accumulated on the compressed nerves. However, they should not be taken without the advice of a health care professional.
Epidural Steroidal Injections
One of the treatment methods used in treating spinal stenosis, is epidural injections. Using a syringe, cortisone is injected either near the narrowing spine region, or directly into the spine. This helps in reducing inflammation and swelling. Once the swelling disappears, there is more space in the spine for the nerves, which in turn helps in to reduce the symptoms. In most cases, about three injections have to be taken in a year.
Alternative therapy like acupuncture, acupressure, massages, magnet therapy, etc. can also help in bringing about changes in the condition associated with spinal stenosis. Most patients find significant relief due to these treatment methods.
Although it can be a difficult task for people with spinal stenosis to lose weight, weight loss helps in reliving pain. After the weight loss, the spine has to support a lesser load, which helps give it immense relief. There are spinal stenosis exercises which may help in treating the condition.
Support Corset or Braces
There are support braces available stores/pharmacies, which are prescribed to help treat this condition. Support braces are used in the case of spinal stenosis affecting the cervical spine, while corsets are used for supporting the lumbar spine.
Rest is usually recommended to treat this condition. Gradual resumption of activity after resting, helps in alleviating the condition. Light aerobic activity like cycling may be recommended after the rest period.
This option is utilized when others fail to do much for the patient. With the surgery, the nerves are decompressed. Depending on the condition, the excess bone, ligament, or soft tissue growth is removed, which gives more space for the nerves. The exact area that goes under surgery depends on where the compression is actually seen. Surgery may be performed, if any of the vertebra has slipped out of its original position.
Spinal stenosis can cause immense discomfort in daily activities as well. If the pain is causing trouble moving around, then you may want to sit down and extend your legs in front of you. Gradually bend down and try to touch your fingers to your toes. Hold the position for sometime and then release. This often helps in alleviating uncomfortable pain. It is recommended that medical help be sought-after immediately, to arrest the problem from worsening.