The spinal cord travels from the brain stem through the vertebrae of the spine with branches innervating the parts of the body. The canal through which the spinal cord runs must be large enough to allow it to move freely. When the space becomes too narrow, it can put pressure on the nerves traveling through the spine. This medical condition is spinal stenosis. It usually occurs in the neck and in the lower back.
Although spinal stenosis can occur anywhere along the spine, there are two main types. They are cervical stenosis, which is a narrowing of the spaces in the neck bones, and lumbar stenosis, which affects the lower part of the back. Between the two, lumbar stenosis is the most common.
Spinal stenosis is a natural part of aging. Many people over the age of 60 have some type of stenosis. Imaging with a CT scan or MRI may show evidence of the condition even though symptoms may not present. Usually, when symptoms do occur, the onset is gradual and will get worse over time. Symptoms can vary. Location of the condition and which nerves are affected determine what symptoms may manifest.
Symptoms of cervical stenosis may include:
- Numbness or tingling. This can happen in the arms, hands, feet or legs
- Weakness in a hand, arm, foot or leg
- Difficulty with walking and keep your balance
- Neck pain
- There may be loss of bladder or bowel control in severe cases
Lumbar stenosis symptoms may include:
- Numbness or tingling in a foot or leg
- Weakness in a foot or leg
- Pain or cramping in either leg or both when standing for long periods of time or when walking; sitting or bending forward eases the pain
- Back pain
Causes of Spinal Stenosis
Your spinal cord is protected by the vertebrae in your spine. These bones form a canal through which the spinal cord travels. When the spinal canal narrows, pressure on the nerves can result in problems. Sometimes a person may be born with a small spinal canal. However, most cases of spinal stenosis are the result of aging or injury:
- Wear and tear from aging can cause overgrowth of the bone. This happens with osteoarthritis and bone spurs form on the vertebrae. When they grow into the spinal canal, they can cause problems. A bone disease affecting adults called Paget’s disease is another source of bone overgrowth.
- Herniated discs can narrow the spinal canal when some of the soft interior of the disk protrudes out from a crack in the hard, outside layer. If it extends into the canal, pressure on the nerves can result.
- Thickened ligaments may bulge into the canal. Ligaments hold the bones of the spine together, and over time they can become stiff and thick.
- Tumors can form inside the spinal cord. This can happen within the membranes that cover the spinal cord or within the space between the spinal cord and the vertebrae. This is a rare occurrence and shows up on MRI and CT scans.
- Spinal injuries from car accidents or other trauma can cause a dislocation or fracture of vertebrae. If a bone is displaced due to a fracture, the contents of the spinal canal can be damaged.
Risk factors for spinal stenosis include age, as the condition mostly affects people over the age of 50. Younger people can have degenerative changes that lead to spinal stenosis; however, it is advisable to rule out other causes. Trauma or congenital spinal deformity may be factors in younger patients. Genetic diseases that affect bone and muscle development throughout the body may also be a factor.
Complications with Spinal Stenosis
Complications with this condition are rare, but when they do develop, it is usually a permanent symptom of numbness, weakness, balance problems, incontinence and sometimes paralysis.
An accurate diagnosis is required for effective treatment. The type of treatment will depend on where the stenosis is located and how severe symptoms are. Patients who have no symptoms are monitored as are those with mild symptoms. Follow up visits help your doctor monitor the progression of the condition. Mild symptoms may call for self-care tips your doctor can recommend. Physical therapy may be advised also.
Spinal stenosis pain can cause individuals to become less active. Inactivity can lead to muscle weakness, resulting in more pain. Physical therapy can help you strengthen your muscles and build endurance. It can also help maintain spinal flexibility and stability while at the same time improving your balance.
Other non-invasive treatments include massage therapy, chiropractic treatment and acupuncture. Manhattan Sports Therapy offers a wide range of non-invasive pain therapies to help reduce the pain of spinal stenosis. Contact us for more information and to schedule a consultation appointment.