Spinal Stenosis

What Is Spinal Stenosis?

Spinal stenosis is created by the narrowing of the spinal canal. This narrowing may be caused by mechanical problems or by abnormalities in the aging spine. It may or may not result in low-back pain, limping, and a lack of feeling in the legs. Stenosis is often a degenerative condition. It may exist for years without causing pain or discomfort, but a fall or an accident can trigger characteristic stenotic pain. Numerous factors can cause stenosis, such as thickened ligaments, expanding infection, abscess, a congenital or developmental anomaly, degenerative changes, vertebral fractures or dislocations, or a spinal cord tumor.

Other conditions, such as a herniated disc, can mimic stenosis. While herniated discs usually cause rapid and acute muscle spasm, discomfort caused by stenosis builds gradually. Other conditions that can be confused with stenosis include vascular claudication, peripheral vascular disease, and abdominal aortic aneurysms. Claudication—pain triggered by walking—caused by vascular disease most often occurs after walking a fixed distance. Patients with spinal stenosis, however, walk variable distances before symptoms set in. Activities like riding a bicycle and walking up a hill can cause pain in patients with vascular claudication, but not in those with stenosis. On the other hand, standing makes pain worse for stenotic patients, while it relieves vascular claudication.

Symptoms of Spinal Stenosis

  • In The Neck (Cervical Spine). Cervical stenosis can cause numbness, weakness or tingling in a leg, foot, arm or hand. Tingling in the hand is the most common symptom, and many people also report problems with walking and balance. Nerves to the bladder or bowel may be affected, leading to incontinence.
  • In The Lower Back (Lumbar Spine). Compressed nerves in your lumbar spine can cause 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.

Causes of Spinal Stenosis

While some people are born with a small spinal canal, most spinal stenosis occurs when something happens to reduce the amount of space available within the spine. Causes of spinal stenosis may include:

  • Overgrowth Of Bone. Wear and tear damage from osteoarthritis on your spinal bones can prompt the formation of bone spurs, which can grow into the spinal canal. Paget’s disease, a bone disease that usually affects adults, also can cause bone overgrowth in the spine.
  • Herniated Disks. The soft cushions that act as shock absorbers between your vertebrae tend to dry out with age. Cracks in a disk’s exterior may allow some of the soft inner material to escape and press on the spinal cord or nerves.
  • Thickened Ligaments. The tough cords that help hold the bones of your spine together can become stiff and thickened over time. These thickened ligaments can bulge into the spinal canal.
  • Tumors. Abnormal growths can form inside the spinal cord, within the membranes that cover the spinal cord or in the space between the spinal cord and vertebrae.
  • Spinal injuries. Car accidents and other major trauma can cause dislocations or fractures of one or more vertebrae. Displaced bone from a spinal fracture may damage the contents of the spinal canal. Swelling of adjacent tissue immediately following back surgery also can put pressure on the spinal cord or nerves.
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How Chiropractic Care Can Help

In many mild and moderate cases of spinal stenosis non-invasive conservative care, such as chiropractic, can help lessen pain and discomfort, maintain joint mobility and allow the patient to keep a reasonable lifestyle, at least for some time. A technique called distraction manipulation may be helpful in reducing leg discomfort. Home exercises are a major part of the conservative treatment program. It is recommended to exercise four or five times a week with physical activities such as riding on the bicycle or lying on the side and grasping the knees with the arms, focus on flexing the spine in a forward position—stretching and strengthening the lower back and stomach muscles and improving muscle strength. Exercises designed to mobilize the involved nerves have been found to be particularly helpful.

Ultimately, spinal stenosis is a chronic condition that cannot be “cured,” but it often can be improved, and improvement can be maintained over the long term. Patients can work with a health care provider, such as a doctor of chiropractic, to reduce symptoms and improve their quality of life.