What is Spinal Stenosis?
Spinal Stenosis Explained by Las Vegas, Summerlin, and Henderson Nevada’s Top Pain Doctors
Spinal stenosis is a condition that develops due to the narrowing of the spinal canal, which causes spinal cord and peripheral nerve impingement. This process results in chronic pain and decreased mobility within the body’s lower extremities. Although spinal stenosis can occur as a congenital condition (a condition detected at birth), it most commonly develops in older patients who have a degenerative disease. People diagnosed with hypertension or scoliosis have been categorized to be predisposed for spinal stenosis.
Patients who suffer from spinal stenosis report a difficulty with walking, being active on a day to day basis, and standing for long periods of time. Symptoms may also include aching pain, a decrease in mobility, and cramping of the lower back that can radiate throughout the thighs and legs. In more severe cases, spinal stenosis can result in lower extremity weakness, bowel incontinence, and loss of sensation within the lower extremities.
What Causes Spinal Stenosis?
The most common cause of spinal stenosis is degenerative arthritis. The everyday “wear and tear” of an aging body can result in arthritis of the spine, which generally leads to spinal stenosis. The condition can develop due to bulging intervertebral discs, bone spurs (osteophytes), or the thickening of soft tissue between the vertebrae in the lower back (lumbar spine), the neck (cervical spine), and in rare occasions, the upper back (thoracic spine).
In some cases, spinal stenosis can occur as a congenital condition, which means that a person is born with a narrowing of the spinal canal. More frequently though, degenerative conditions of the spine are responsible for the development of spinal stenosis. Factors such as being overweight, having unbalanced alignment, poor posture, overextending the back and spine on a day to day basis, and a history of back pain or injury can result in the condition. People who have had family members with spinal stenosis or chronic lower back pain are thought to have an increased risk due to heredity.
Treatments for Spinal Stenosis
In order to diagnose spinal stenosis, a physician will review a patient’s medical history and perform a physical examination of the spine and lower extremities to monitor the amount of mobility and sensation felt by the patient. Radiological imaging, such as X-rays, MRIs, ultrasound, and CT scans will normally be used by the physician as well in order to visualize the severity of the condition before administering a treatment plan.
Non-surgical forms of treatment are commonly recommended and have been found to be effective in spinal stenosis patients. Non steroidal anti-inflammatory drugs (NSAIDs) and opioid medications are often prescribed as part of a daily treatment regimen. In addition, therapies such as epidural steroid injections, adhesiolysis, and spinal cord stimulation have proven to be successful.
Patients sometimes prefer alternative treatments that do not require prescription medication. Techniques such as acupuncture, dietary changes, massage, and yoga have shown to have a positive effect on spinal stenosis. Alternative therapies are also beneficial to patients who are unable to undergo surgical treatment due to existing health conditions.
In severe cases, surgical treatment may be recommended when all other types of conventional therapies have been proven unsuccessful. Those patients who experience severe pain, decreased sensation in the lower extremities, and loss of bladder and bowel functions are typically the best candidates for surgery. Surgical treatment for spinal stenosis is typically invasive and painful, but necessary due to a build- up of pressure and inflammation surrounding the spinal cord.
Spinal stenosis is a condition that develops due to the narrowing of the spinal canal, which results in spinal cord and peripheral nerve impingement. Although congenital stenosis can occur, the most common cause is due to degenerative arthritis. Those afflicted with spinal stenosis report difficulties walking, standing, and actively functioning on a day to day basis. Other symptoms that may occur are aching pain, cramping within the lower extremities, and in critical cases, extremity weakness and loss of sensation. Studies have shown non-surgical treatments, such as non steroidal anti-inflammatory drugs (NSAIDs), epidural steroid injections, and acupuncture to be successful in most cases. For patients who have found conservative types of treatment ineffective or who are suffering from severe chronic symptoms, surgery may be recommended by a physician.
- Aalto TJ, Malmivaara A, Kovacs F, et al. Preoperative predictors for postoperative clinical outcome in lumbar spinal stenosis: systematic review. Spine (Phila Pa 1976). 2006;31:E648–63.
- Atlas SJ, Delitto A. Spinal stenosis: surgical versus nonsurgical treatment. Clin Orthop Relat Res. 2006;443:198–207.
- 3. Ciol MA, Deyo RA, Howell E, et al. An assessment of surgery for spinal stenosis: time trends, geographic variations, complications, and reoperations. J Am Geriatr Soc. 1996;44:285–90.
- Deyo RA, Gray DT, Kreuter W, Mirza S, Martin BI. United States trends in lumbar fusion surgery for degenerative conditions. Spine. 2005;30:1441-1445.
- Kapural L, Mekhail N, Bena J, et al. Value of the magnetic resonance imaging in patients with painful lumbar spinal stenosis (LSS) undergoing lumbar epidural steroid injections. Clin J Pain. 2007;23:571–5.
- Lebude B, Wang D, Harrop JS, et al. Clinical survey: patterns of utilization of lumbar epidural steroid injections by a cohort of spinal surgeons. PM R. 2009;1:329–34.
- Mirtz TA, Greene L. Is obesity a risk factor for low back pain? An example of using the evidence to answer a clinical question. Chiropr Osteopat. 2005;13:2.
- Simotas AC. Nonoperative treatment for lumbar spinal stenosis. Clin Orthop Relat Res. 2001;384:153-61