Spinal Stenosis

What is Spinal Stenosis?

It is a narrowing of one or more areas in your spine — mostly in your upper or lower back. This narrowing can put pressure on your spinal cord or on the nerves that branch out from the compressed areas.

Doctors categorize stenosis as either primary or acquired:

• Primary Spinal Stenosis, which is relatively uncommon, is present at birth.
• Acquired Spinal Stenosis, which is the type that most people have, develops later in life. It's usually a result of degenerative changes in the spine that occur with aging.

This narrowing can cause cramping, pain or numbness in your legs, back, neck, shoulders or arms; a loss of sensation in your extremities; and at times may cause problems with bladder or bowel function. It is most commonly caused by osteoarthritis-related bone damage.

You can also help relieve these symptoms by increasing the antioxidants in your diet with high ORAC Value such as fruits and vegetables , acaiberries , blueberries , and dark chocolate . Increasing the antioxidants in your daily diet has been proven to decrease inflammation.

What are the Symptoms of Spinal Stenosis?

Spinal narrowing doesn't always cause problems. You're more likely to develop signs and symptoms if the narrowed areas compress the spinal cord or spinal nerves. These often start gradually and get worse over time.

The most common signs and symptoms of Spinal Stenosis include:

• Pain or cramping in your legs Compressed nerves in your lower back can lead to a condition called pseudoclaudication, false claudication or neurogenic intermittent claudication, which causes pain or cramping in your legs when you stand for long periods of time or when you walk.

  The discomfort usually eases when you bend forward or sit down, but it persists if you continue to stand upright.

• Radiating back and hip pain A herniated disk can narrow your spinal canal and compress nerves in your lumbar spine, leading to pain that starts in your hip or buttocks and extends down the back of your leg. The pain is worse when you're sitting and generally affects only one side.
• Pain in your neck and shoulders This will usually occur when the nerves in your neck are compressed. The pain usually occurs only occasionally or it may be chronic, and it sometimes can extend into your arm or hand.

  In addition, the spinal cord is sometimes compressed, which can result in lower extremity weakness and difficulty walking. You also may experience headaches, a loss of sensation or muscle weakness.

• Loss of balance: Pressure on the cervical (neck) spinal cord can affect the nerves that control your balance, resulting in clumsiness or a tendency to fall.
• Loss of bowel or bladder function (cauda equina syndrome): In severe cases, nerves to your bladder or bowel may be affected, leading to partial or complete urinary or fecal incontinence. If you experience either of these problems, seek medical care right away.

What are Some Causes of Spinal Stenosis?

The main cause of spinal degeneration is osteoarthritis. This is an arthritic condition that affects the cartilage that cushions the ends of bones in your joints. With time, the cartilage begins to deteriorate and its smooth surface becomes rough.

If it wears down completely, bone may rub painfully on bone. In an attempt to repair the damage, your body may produce bony growths called bone spurs. When these form on the facet joints in the spine, they narrow the spinal canal.

When do I Seek Medical Advice?

Some people ignore the signs and symptoms of spinal stenosis. They believe that the pain and stiffness they experience are a normal part of aging, or hope that they will go away, but discomfort that interferes with your mobility is not normal.

Seek medical advice if you have pain, stiffness, numbness or weakness in your back, legs, neck or shoulders that is not related to exercise or overexertion.

Spinal stenosis is especially likely if you have leg pain that gets worse when you walk and improves when you sit or bend forward. Get immediate care if you suddenly have trouble controlling your bowels or bladder.

What are Some Treatments and Drugs for Spinal Stenosis?

Lots of people with Spinal Stenosis are effectively treated with conservative measures, but if you have disabling pain or your ability to walk is severely impaired, your doctor may recommend spinal surgery.

Acute loss of bowel or bladder function is usually considered a medical emergency and requires immediate surgical intervention.

Before considering surgery, your doctor most likely will recommend trying one or more of the following nonsurgical treatments for at least three months:

• Physical Therapy: A Physical Therapist can work with you to build up your strength and endurance and help maintain the flexibility and stability of your spine.
• Pain Medications: These include over-the-counter and prescription medications, such as aspirin or ibuprofen. Medications can cause bad side effects sometimes. You should always read labels before using.
• Chondroitin Sulfate and Glucosamine or Everflex These nonprescription supplements, used either alone or in combination, have shown positive effects on osteoarthritis. But it's not yet known whether they're effective at treating or preventing osteoarthritis of the spine.

  Talk to your doctor if you're interested in these supplements because they may interfere with other medications you're taking, especially warfarin (Coumadin).

• Rest or Restricted Activity: Moderate rest followed by a gradual return to activity may improve symptoms. Walking is usually the best exercise, but biking also is recommended because it keeps your back in a flexed position rather than in an extended one.
• A Back Brace or Corset: Back braces or corsets provides support and may especially benefit people who have weak abdominal muscles or degeneration in more than one area of the spine.
• Epidural Steroid Injections: In some cases, your doctor may inject a corticosteroid medication into the spinal fluid around your spinal cord and nerve roots. They can suppress inflammation and can be especially helpful in treating pain that radiates down the back of your leg. In fact, a single dose may provide significant relief.

  But because corticosteroids can cause a number of serious side effects, the number of injections you can receive is limited, usually to no more than three in one year.

The goal of surgery is to relieve pressure on the spinal cord or nerves and to maintain the integrity and strength of your spine. This can be accomplished in several ways, depending on the cause of the problem. The most common surgical procedures include:

• Decompressive Laminectomy: In this procedure, your surgeon removes all of the lamina (the back part of the bone over the spinal canal) to create more space for the nerves and to allow access to bone spurs or ruptured disks that may also be removed.

  A laminectomy is often performed through a single incision in your back (open surgery), although in some cases, your surgeon may use a laparoscopic technique. In that case, a tiny camera and surgical instruments are inserted through several small incisions, and your surgeon views the operation on a video monitor.

  Laparoscopic back surgery is complex and requires great skill and is not appropriate for many people with spinal stenosis. When done properly, however, you're likely to have less pain and to recover from surgery more quickly with this technique. Risks of laminectomy include infection, a tear in the membrane that covers the spinal cord at the site of the surgery, bleeding, a blood clot in a leg vein, decreased intestinal function (paralytic ileus) and neurological deterioration.

• Laminotomy: In this procedure, just a portion of the lamina is removed to relieve pressure or to allow access to a disk or bone spur that's pressing on a nerve. The risks are the same as for laminectomy.
• Fusion: This procedure may be performed on its own or at the same time as laminectomy. It's used to permanently connect (fuse) two or more vertebral bones in your spine and may be especially indicated when one vertebra slips over another.

  To fuse the spine, small pieces of extra bone are needed to fill the space between two vertebrae. This may come from a bone bank or from your own body, usually your pelvic bone. Wires, rods, screws, metal cages or plates also may be used, especially if your spine is unstable or the operation takes place to correct a deformity.

Back surgery can relieve pressure in your spine, but it's not a cure-all spinal stenosis treatment. You may have considerable pain immediately after the operation, and you might continue to have pain for a period of time. For some people, recovery can take weeks or months and may require long-term physical therapy. What's more, surgery won't stop the degenerative process, and symptoms may return — sometimes within just a few years.

What are Some Lifestyle and Home Remedies?

You can't always prevent age-related changes in your back, but the following steps can help keep your spine and joints as healthy as possible:

• Exercise Regularly: Exercise helps maintain strength and flexibility in your spine, joints and ligaments. Combine walking and biking with weight training and stretching for best results. Toning and stretching before exercise can help reduce wear and tear on your back.

  It also reduces your risk of injury by warming up your muscles and increasing your flexibility. Start out gradually and increase the duration and intensity of your workout as you become stronger. Aim for at least 30 minutes of moderate exercise on most days.

• Use Good Body Mechanics: Being conscious of how you sit, stand, lift heavy objects and even how you sleep can go a long way toward keeping your back healthy.
• Before You Lift Something Heavy: Think about where you'll place it and how you'll get it there. Pushing is safer than pulling. Always bend your knees so that your arms are level with the object. Avoid lifting overhead.
• When You Sit: Choose a seat that supports your lower back to minimize stress. If necessary, place a pillow or a rolled towel in the small of your back to maintain its normal curve. When you drive, adjust your seat to keep your knees and hips level, and move the seat forward to avoid overreaching for the pedals.
• For The Best Sleep Posture: Choose a firm mattress. Use pillows for support, but don't use one that forces your neck up at a severe angle.
• Maintain a Healthy Weight: Extra weight puts additional stress on your joints and bones. Please see my Weight Loss Tips page.
• Eat a Variety of Fruits and Vegetables: Give your body the support it needs by increasing your antioxidants found in fruits and vegetables and other antioxidant-rich foods to help decrease inflammation in joints and help prevent other disease such as high blood pressure , heart disease and cancer.
• Take Natural Supplements Daily. Help your body build an immune system to help fight these diseases. You can build strong bones and joints by taking natural supplements.
  
  

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  Information on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional.
  
  
  

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