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 a reduced range of motion.
Though many may not experience symptoms for some time, it is estimated that between 250,000 and 500,000 US residents have or are developing some form of spinal stenosis. The condition is more prevalent with older 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 the degradation of the tissues within the spine and has even been linked to degenerative illnesses such as osteoarthritis.
Spinal Stenosis Causes 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’s 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
- Balance and coordination issues
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 exertion such as walking or standing for long periods
- Legs have a reduced range of motion
- Balance and coordination issues
- 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 over time, if minor movements incite the symptoms, or if stretching of the neck or lumbar creates a flare-up, spinal stenosis is more than likely part of the issue.
Spinal Stenosis Diagnosis
A routine examination for spinal stenosis begins with a look into the patient’s medical history. Past injuries to the back as well as the 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 that 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 that involve 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 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, CT 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.
Conventional Treatments for Spinal Stenosis
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 to achieve greater results. Some of the most common treatments for spinal stenosis include physical therapy, medication, steroidal injections, and surgery. Each treatment helps differently and requires a different level of engagement from the patient to be successful.
Physical Therapy for Spinal Stenosis
Physical therapies (PT) are a 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 therapy and if practiced improperly, they may escalate the issue.
Medication for Spinal Stenosis
Typically, doctors will begin by recommending the use of over-the-counter medication, rather than prescription. 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 your perception of pain. If you regularly take other medication, mention it to your doctor so he can make the proper adjustments. 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 the last resort for any type of injury, doctors are especially wary of recommending surgery for spinal stenosis. Recovery periods are long and the use of prescription pain medication in the healing process is almost always anticipated.
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 stem cells known as mesenchymal stem cells. These stem cells are derived from adult tissues such as bone marrow. By extracting bone marrow directly from the patient, processing it, and reinjecting these cells into the site of an injury, the treatments will amplify the body’s natural healing processes and provide it with an ample amount of growth factors 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 to place the stem cells exactly where they will have the most impact.
The benefits to stem cell injections over conventional treatments is that they are minimally invasive and not only treat the symptoms but the causes as well. As a result, these treatments last much longer than conventional treatments.
Furthermore, treatments are outpatient procedures with short recovery times. Most patients experience soreness for several days after the injection, but report pain relief that lasts from 6 months to a year thereafter.