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Spinal Stenosis

Spinal Stenosis

This article provides a range of different approaches an individual can take in order to manage back pain and all the sciatica symptoms that are associated with lumbar spinal stenosis, including staying active and exercising, pain management, biomechanical awareness and nutrition.
Natasha Bantwal
Last Updated: Mar 8, 2018
Spinal Stenosis is the narrowing of the spinal canal, which occurs when there is excessive growth of bone or tissue that reduces the size of the openings in the spinal bone. Spinal Stenosis occurs most commonly in the lumbar area (the lower back). If at all it occurs in the cervical area (the neck), the spinal cord may get squeezed, which could result in paralysis and nerve damage if left untreated. Most people suffering from spinal stenosis will find that they can successfully control their condition by going for a few easy self-care programs.
A Brief Introduction
As we age, our bodies will inevitably go through a number of changes. In the spine, the vertebrae will sometimes develop arthritis, the intervertebral discs may start to bulge and the ligamentum flavum may start to buckle - all these changes, whether in combination or alone, can lead to this health condition.
The condition is essentially called a 'Stenosis', which is the Greek word for 'choking'. There are two basic types of lumbar spinal stenosis:
  • Foraminal Stenosis - When the foramen, where the nerve roots exit the spinal canal, becomes tighter.
  • Central Stenosis - when the central region of the spinal canal becomes tight.
Not everyone with MRI, X-rays, and CT scan findings suffer from the symptoms. In fact, just like with osteo-arthritis of the hip or the knee or any of the other sources of severe back pains, imaging results and findings don't necessarily correlate with the degree of symptoms. Simply put, symptoms may be much worse or even less severe that one would usually suspect when looking at the degree of stenosis on imaging findings.
Symptoms
The symptoms usually include numbness, leg pain (sciatica), burning sensation and tingling. In more severe cases, there could also be weakness in the legs. The symptoms usually develop over a period of time and are intermittent and tend to get worse during such activities wherein the patient is required to bend his or her trunk backwards while the pain appears to get better if the patient leans forwards.
In fact, most patients will say that they don't feel any pain or symptoms when in a grocery store, because they tend to lean forwards when shopping. By leaning forwards or flexing forwards, the spinal canal will 'open up' and the pressure will then be taken off the nerve roots and nerves. Walking uphill is also less painful and easier for people who are suffering from this condition. Patients suffering from symptoms of numbness, leg pain, burning, tingling, and/or weakness will need to get evaluated by their doctor in order to get an accurate diagnosis for the cause of their problems. There could be other problems like vascular claudication causing these symptoms.
Treatment Options
After being diagnosed, there are many different self-care activities that can help keep your symptoms under control. Here are the four key components of any self-help program to manage the symptoms.
Staying Active and Exercising
Staying active is very important when it comes to managing the symptoms. The key is to finding activities that will interest you. Exercise is extremely good for the joints as it will increase blood flow to the lumbar area, bringing along with it nutrients and oxygen, and washing away all the toxic metabolites. Exercise helps to strengthen the muscles surrounding the spine, which in turn takes the pressure off the bones in the back. Exercise increases flexibility that prevents the tightening of muscles. Some activities that people should engage in are - cycling, stationary biking, swimming, joining a gym and working with a trainer or therapist, and Tai Chi.
Pain Management
Some home-based pain management include putting ice packs on the lower back, applying heat over tightened muscles, using a topical pain reliever or even a good massage. Over-the-counter medications would include NSAID's and acetaminophen. All these medications have some side effects as well. If symptoms are progressive, severe or are interfering with your daily life, then it is good to consult a doctor for different treatment options. There are lots of pain management techniques like prescription medication, exercises, physical therapy, injections, and even surgery.
Biomechanical Awareness and Posture
The back is probably one of the most hardworking parts of our body; it works with practically every activity - right from sitting in a chair to changing positions to picking something off the floor. The back is designed to do all sorts of work, but it is very important to do all kinds of activities in a healthy way. Posture is very important and care should be taken to keep the back as straight as possible at all times. Good posture involves standing with the full weight of your body on the balls of your feet, not slouching forwards, keeping the head right over the neck, and so on. Your mattress has to offer support so a medium firm mattress will be ideal.
Nutrition
Yes, you are what you eat. Eat healthy, stay hydrated, eat lots of vegetables and fruits, don't consume alcohol, don't smoke, minimize consumption of red meat and caffeine, and you'll look and feel healthy again. Maintaining a healthy weight will reduce your body's propensity towards swelling and inflammation and will keep your tissues and spinal discs well hydrated, thus reducing the pain.
None of these treatment options can change your spinal structure. However, these options can definitely help reduce or eliminate the symptoms that come along with spinal Stenosis. However, if symptoms worsen or persist, there are still quite a few treatment options that can be offered before you go into surgery, and if the symptoms prove to be debilitating, then there are many surgical options that could benefit you.
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