Spinal Stenosis
Commonly asked questions about Spinal Stenosis
What is a spinal stenosis?
Spinal stenosis is a narrowing of the spinal canal, and is caused by a number of things. If there is narrowing of the central canal or of the tunnels where the nerves exit the canal, there can be irritation of the nerves. The causes of spinal stenosis may include disc bulging or herniation, as well as arthritic bony build-up of the joints of the spine due to normal aging.
What are the symptoms of spinal stenosis?
Typically, patients with spinal stenosis can have back and leg pain, or neck and arm pain, and sometimes numbness and tingling in the affected limbs. The back and leg symptoms may be worse with standing or walking, and is often relieved when sitting.
What treatment options are available for spinal stenosis?
Spinal stenosis is a condition that usually has taken years to develop, and there are no easy answers to the problem. The most important plan for treatment is modification of activity. Because the pain may be related to irritation and inflammation of the nerves, anti-inflammatory medication is commonly prescribed for this condition. This is generally given as a pill to be taken by mouth. Some patients cannot tolerate anti-inflammatory medications, or they are not effective, and other pain medications may be tried in these cases. Chiropractic treatments may also be beneficial in selective patients. Epidural steroid injections, which involve placing a combination of local anti-inflammatory steroid medication into the area of the spinal narrowing, are effective for many patients. Occasionally, repeat injections are needed depending upon the individual’s response. Once the pain is under better control, physical therapy programs may be helpful to teach a patient how to decrease the risk of ongoing pain.
What is the prognosis for patients with spinal stenosis?
The prognosis for a patient with spinal stenosis depends in large part on the cause of spinal canal narrowing. If a disc herniation or bulge is responsible for the narrowing, appropriate treatment with physical therapy, medications and possible steroid injection can significantly help patients. If underlying arthritic change is responsible for the narrowing of the spinal canal, then pain control is typically the main goal. Arthritic change may progress to some degree, but with appropriate exercise and activity modification, most patients remain very functional with manageable pain.
Is there anything I can do to prevent spinal stenosis?
Because spinal stenosis develops over years, it is important to maintain good life-long back care and understand what one can do to decrease the risk of spinal degeneration. Spine care specialists such as physicians, physical therapists and chiropractors can help design an effective program. Regardless of the cause for spinal stenosis, it is important for patients to stay as active as possible to maintain the best function.
Is surgery a viable option for patients with spinal stenosis?
If a disc herniation is the underlying cause of the spinal stenosis, surgery can be a viable option. However, surgery is only reasonable for specific reasons, including progressive loss of strength in the legs or arms, loss of bowel or bladder function or significant pain that hinders a patient's ability to perform day-to-day activities. Surgery is less effective if arthritic change is the main cause of the spinal narrowing, but may in some cases give reasonable intermediate relief. Longer-term relief is less certain.
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