Spinal Stenosis 101: Everything You Need to Know about it
As per the American Academy of Orthopedic Surgeons, spinal stenosis affects almost 8 to 11 percent of the total population and is very common in individuals over the age of 50.
In the simplest sense, spinal stenosis is a condition in which the spinal cord or nerves are compressed by surrounding structures.
When it comes to spinal stenosis, the first thing to understand is there is no simple cure. However, there are treatments available for spinal stenosis that can significantly improve symptoms.
Everything you need to know about spinal stenosis
- An overgrowth of the bone from conditions like osteoarthritis, results in the occurrence of bone spurs which can further grow into the spinal canal.
- Next, herniated discs, which are in the simplest sense, shock absorbers between the vertebrae, tend to lose their impact over time with age. They may bulge and contribute to spinal stenosis.
- Thickened ligaments are also an important contributor for spinal stenosis.
- The growth of tumours can also cause the condition to arise and worsen if left untreated. They mostly grow within the membranes and spread between the spinal cord and vertebrae.
- Injuries to the spinal cord, in terms of an accident, which causes fracture or dislocation further leads to swelling, that causes pressure on the spinal tissues.
- Lastly, achondroplasia, which is a type of dwarfism which predisposes the individual to spinal stenosis.
- In the neck region, the cervical spine, the common symptoms include numbness in the arm or legs, weakness while doing everyday activities, issues with walking and balance, neck pain and in rare cases, bowel or bladder dysfunction.
- Coming to the lower back, you can find numbness or slight tingling in the legs or feet, weakness in the limbs, cramping or severe pain if you stand for long and grave back pain.
- Sciatica or pain that radiates into the thighs and legs is also a symptom of spinal stenosis.
- Foot drop i.e. shooting pain in the legs causing you to “slap” your foot suddenly on the ground is also an indication.
Firstly, it is important to remember that a condition like spinal stenosis cannot be determined from physical examination and usually requires further investigation. Even if a doctor feels the symptoms point towards this condition, he or she will still ask for a scan to determine the exact diagnosis and then guide the patient towards the treatment.
- CT scan, MRI scan and X-rays are the most common investigations used to help the doctor understand the condition.
- Nerve Conduction Studies (NCS) / Electromyography (EMG) may be helpful in determining the condition of the spinal nerves.
- CT Myelogram is a type of CT scan, usually reserved for those unable to have an MRI, and helps to determine compression of the spinal cord or nerves.
Nerve tests are used to understand the underlying issues in the motor and sensory nerves of the human body. Some neurophysiologists might also consider EMG and NCS testing.
- NCV, or Nerve Conduction Velocity is one of the nerve tests for spinal stenosis to determine abnormal conditions in the nerves. This one is done along with the EMG in most cases, to determine nerve and muscle conditions simultaneously.
- Another important nerve test for spinal stenosis is SSEP, or Somatosensory Evoked Potential. This one helps to understand the electrical signals sensations that go from the body to the brain and spinal cord.
- A Nerve Conduction Study is another way in which doctors attach small, flat electrodes to the patients’ skin. These cover the nerves and muscles, and the machine is able to determine how quickly the corresponding muscles are able to contract. If it does not happen right away, then there are chances of interference with its functioning.
Although spinal stenosis has no direct cure, with the right methods, the pain and effects can be controlled. However, complications can occur if it is left untreated and also with the wrong diagnosis and treatment.
Some of the complications that can occur without treatment include permanent nerve damage which can mean long-term pain, numbness, weakness or bladder and bowel dysfunction.
Thankfully, there are a few treatment options available depending on the severity pf the patient’s symptoms and the MRI findings.
- Physical therapy / physiotherapy for spinal stenosis may help patients regain some of their function
- Laminectomy (decompression) is a surgical procedure in which a surgeon uses an incision to reach the spine. The excess bone growths, ligaments etc. are trimmed or removed to give the spinal cord / nerves more space. Some doctors might also consider laminotomy or laminoplasty.
- Discectomy is the removal of the disc that is compressing the spinal nerves. This method also helps to resolve symptoms.
- Spinal fusion is done to stabilize bones to avoid movement. Bone grafting or metal hardware is used in this case.
Lifestyle and home remedies
- Exercising regularly can help control a lot of the pain due to spinal stenosis.
- Hot showers and cold compress may help target the pain directly.
- Try to lose weight as extra pounds can worsen the condition.
- Quit smoking, as it causes spinal discs to wear faster.