Spinal stenosis is a condition in which the spaces within the spine narrow and put undue pressure on the nerves within.
This pressure can irritate the nerves and create a range of symptoms from minor aches and tingling to chronic pain and reduced range of motion.
Though many may not experience symptoms for some time, it is estimated that between 250,000-500,000 US residents have or are developing some form of spinal stenosis. The condition is more prevalent as we age – roughly 5 of every 1000 people over the age of 50 may be developing the issue.
This comes as no surprise as spinal stenosis is most typically caused by degradation of the tissues within the spine and has even been linked to degenerative illnesses such as osteoarthritis.
If you believe you may be experiencing the onset of spinal stenosis, continue on to learn more about how it begins, what symptoms to look for, and how it can be treated before it becomes a life-altering issue.
Spinal Stenosis Cause and Symptoms
The spine is one of the most innervated portions of the body. It is used as a sort of highway for the brain to send and receive electrical impulses from our various organs, muscles, and other tissues. Due to its prolific amount of nerves, any slight malfunction or degeneration within the spine can have a huge impact on a person lifestyle.
In the case of spinal stenosis, the spaces between the vertebrae which make up the spine compress and pinch the nerves between them. This narrowing of space most often happens within the neck (cervical spinal stenosis) or the lower back (lumbar stenosis). While both types share similar symptoms, the portions of the body in which the symptoms express themselves vary.
Cervical Stenosis Symptoms
- Numbness throughout the limbs – hands, feet, arms, or legs
- Neck aches
- Reduced grip strength in the hand
- Reduced flexion of the arm or leg
Lumbar Stenosis Symptoms
- Numbness in the lower body – feet or legs
- Weakness of the foot or leg
- Cramps and aches in the legs after minor physical excursion such as walking or standing for long periods of time
- Reduced range of motion of the legs
- Back pain
Though these symptoms are not specific to spinal stenosis, the way they manifest themselves can be a good indicator that stenosis may be the root issue. If the pain emerges and becomes worse overtime, if minor movements incite the symptoms, or if stretching of the neck or lumbar create a flareup, spinal stenosis is more than likely part of the issue.
Spinal Stenosis Diagnosis
A routine check for spinal stenosis begins with a look into the patient’s medical history. Past injuries to the back as well as age of the patient are some of the most important factors to consider when diagnosing a possible case of stenosis of the spine.
Past injuries can cause acute damage to the structures within the spine which may cause malformations which lead to compressed nerves. As we age, we also lose valuable soft tissues which cushion the vertebrae of the spine from one another. As this tissue degrades, the spine compresses and can begin to pinch the nerves between each vertebra.
Physical examinations involving stretching the spine or applying pressure to specific parts of the back may also be used. These tests aim to recreate the pain a person feels so as to isolate the pain to a specific portion of the back as well as narrow down the possible inciting factors of the pain.
Finally, medical imaging such as MRIs, CAT Scans, and X-Rays can provide a clearer view of the internal structures of the spine and help doctors determine their current condition and whether stenosis is the likely cause.
If spinal stenosis is the ultimate diagnosis, doctors have a range of treatment options they typically recommend. Based on the patient’s functional goals, doctors will create a plan to determine how best to meet those goals.
Spinal Stenosis Conventional Treatments
Conventional treatments for spinal stenosis aim to relieve pain and help patients to continue their regular activities. These treatments can be used alone or may be combined with each other in order to achieve greater results. Some of the most common treatments for spinal stenosis include physical therapy, medication, steroidal injections, and surgery. Each treatment helps in a different way and requires a different level of engagement from the patient in order to be successful.
Physical Therapy for Spinal Stenosis
Physical therapies are popular option for any back issue, not just stenosis. PT is simply any treatment by physical means. Massage, hot/cold therapy, guided stretching (such as yoga), exercise, and compression (binding) are some of the most popular physical therapies used for treating symptoms of spinal stenosis.
These treatments are so widely used because they are simple, can be done at a patient’s leisure, and are economically viable. The drawback to these treatments is that they may not be as effective as other treatments in dealing with specific issues related to spinal stenosis, for instance, degenerated tissues cannot be brought back through physical therapies and if practiced improperly, they may escalate the issue.
Medication for Spinal Stenosis
Typically, doctors will begin by recommend the use of over-the-counter, rather than prescription medication. Naproxen, ibuprofen, and acetaminophen are some of the most widely available drugs available and help to treat the pain and inflammation associated with spinal stenosis.
If these medications fail to provide relief, doctors may recommend stronger medications aimed at reducing the brains reaction to pain. Any prescription medication should be heavily researched before adding it to a medication routine. Side effects can vary from person to person and may inflame the symptoms and causes of spinal stenosis.
Steroidal Injections for Spinal Stenosis
Once thought to be a miracle cure for soft tissue pains throughout the body, steroidal injections have recently come under scrutiny amongst the medical community. The latest research shows that while these treatments can provide immediate relief from pains associated with soft tissue damage, they can also amplify the breakdown of these tissues if not used sparingly.
Surgery for Spinal Stenosis
Typically a last resort for any type of injury, doctors are especially weary of recommending surgery for spinal stenosis. Recovery periods are long and the use of prescription painkillers in the healing process is almost always anticipated.
While success rates are high, the recovery periods and use of medication may be enough to turn patients away from surgery.
If conventional treatments fail to meet a patient’s functional goals, or if the side-effects and recovery periods are too much for a patient, there are a wide variety of alternatives to consider. One of the most prolific of these treatments is regenerative therapy.
Stem Cell Therapy for Spinal Stenosis
While stem cell therapy is nothing new, recent developments have led to the discovery of less morally ambiguous stem cells known as mesenchymal stem cells. These stem cells are derived from adult tissues such as fat and bone marrow and behave similar to the embryonic stem cells used in the past.
By extracting adipose (fat) or bone marrow directly from the patient, processing it, and reinjecting these tissues into the site of an injury, the treatments aim to amplify the body’s natural healing processes and provide it with an ample amount of tissues to perform repairs.
Once inside the body, the stem cells latch onto an injury and create an environment suitable for repair. From there, they send out chemical impulses which attract the body’s healing factors to the site of the injury and then help boost their effects.
In cases of spinal stenosis, doctors can use special medical imaging procedures in order to place the stem cells exactly where they will have the most impact. Once inside the spine, the injections help to tighten loose ligaments and reduce the pressure around the nerves. These injections can also help reduce swelling and reverse the breakdown of the joints which cause stenosis.
The benefits to stem cell injections over conventional treatments is that they are minimally invasive and help not only treat the symptoms of stenosis, but the causal factors as well. By treating the causes rather than just the symptoms, these treatments last much longer than conventional treatments.
Furthermore, treatments are simple outpatient procedures with minimal recovery times. Most patients experience soreness for several days after the injection, but report relief which lasts from 6 months to a year thereafter.
Spinal stenosis can cause a range of symptoms which reduce the quality of a person’s life. Activity levels go down, pain increases, and people are left debilitated once the stenosis really sets in. While conventional treatments may be helpful at minimizing the symptoms, they can not treat the root causes of the issue and may at times make matters worse.