Spinal Stenosis - A Brief Overview

Your doctor has told you that you have stenosis of the spine--what exactly does that mean? It sounds mysterious and frightening, but as with all things medical a little basic understanding of what the term refers to goes a long way towards easing your mind and propelling you forward in dealing with your diagnosis.

What is Spinal Stenosis?

Simply put, stenosis is a narrowing of the spaces between the bones of your spine, and is by and large a product of the natural aging process. As we grow older we are more prone to inflammation (such as rheumatoid and osteoarthritis) and structural changes; our ligaments may thicken and calcify, and our bones and joints may actually begin to enlarge, all of which can alter the basic architecture of our backbones and impinge on spaces that were, in our younger years, more than adequate. There are other causes of stenosis as well, including trauma, tumors and bone diseases but the most common causes are related to the degenerative processes of aging.

There are three major areas where stenosis may occur. The first is in the spinal canal itself—the cavity through which our spine cords and nerves run the length of the bony column of our vertebrae. The second is in the canals that branch out from the spinal cord where nerves are rooted to the cord. The third area is the openings between the individual vertebrae where nerves connect to other parts of the body. Changes anywhere in our spinal columns will result in increased stress and pressure on the whole of the spinal system, causing collateral pain and discomfort.

Because it results from a degeneration of the structures of the spine, stenosis may progress for many years without causing significant symptoms, the disorder is often marked by a gradual onset of pain, numbness or weakness of the back and neck. The pain may be localized, or general, express as cramping or or radiating along nerve pathways as is the case with sciatica, where pain travels down into the legs. More severe cases of stenosis—thankfully rare, can result in disruption of the normal functioning the bladder and bowel, and cause severe weakness and loss of feeling in one or both legs.

Spinal Stenosis Treatment

The good news about stenosis is that it can, by and large, be managed effectively by non surgical treatments, as with any condition, surgery should be considered as a last resort, or when there is a real danger of severe or progressive nerve damage from the condition. Some of the traditional approaches are listed below:

Prescribed or over the counter use of NSAIDs (non steroidal anti inflammatory drugs, i.e. aspirin, ibuprofen, naproxen sodium) which relieve pain as well as reducing inflammation.
Prescribed or OTC use of analgesics (i.e. acetominiphen)
Injections into the outer membranes of the spinal cord and nerve roots of corticosteroids (especially indicated for cases of severe radiating sciatic pain into the hips and legs)
Nerve block injections of anesthetics near a particular nerve the aim of which is to temporarily relieve severe discomfort
Restricted activity
Physical therapy, and /or a regimen of independent exercises targeted to strengthen abdominal and back muscles which help stabilize the spine, which can include low impact aerobic exercises such as swimming and biking.
Use of braces or corsets specifically designed to provide lumbar support—this last is generally reserved for those who have degenerative processes involving several spinal levels.
Another option to surgical treatment may be what is commonly referred to as “alternative therapies” such as chiropractic manipulation and acupuncture, though most doctors will recommend the latter only in addition to the more standard treatment regimens.

Spinal Stenosis Surgery

Surgical intervention in the treatment of stenosis may ultimately be necessary if relief from the condition is not achieved through non surgical methods. Any surgical procedure carries inherent risks which increase with advancing age, spinal surgery –due to the delicate nature of the spinal cord and nerve roots—has the added risks of damage to membranes of the spinal cord, localized infections and blood clots which are considered manageable complications but can affect ultimate outcome and recovery time.

Surgery may also only offer a temporary cessation of the degenerative processes that cause the disorder, but it is generally considered by the experts as being the best option to significantly restore function and relieve pain. It must be stressed, however, that non surgical treatments have also been proven to relieve pain and restore function, if on a somewhat more limited basis. As always, the decision must be yours!