Spinal Stenosis

What is spinal stenosis?

Stenosis means narrowing. In spinal stenosis, the spinal canal, which contains and protects the spinal cord and nerve roots, narrows and pinches the spinal cord and nerves. This can occur in the neck or back.  Stenosis may pinch the nerves that control muscle power and sensation in the arms or legs.

What causes spinal stenosis?

There are many potential causes for spinal stenosis, including:

  • Aging. As you get older, the ligaments (tough connective tissues between the bones in the spine) can thicken. Spurs (small growths) may develop on the bones and into the spinal canal. The cushioning disks between the vertebrae may begin to deteriorate. The facet joints (flat surfaces on each vertebra that form the spinal column) also may begin to break down.
  • Heredity. If the spinal canal is too small at birth, symptoms may show up in a relatively young person.

What are the symptoms?

  • In the neck, symptoms may include arm pain and difficulty manipulating small objects
  • In the back, symptoms may include leg pain and difficulty walking aggravated by activity
  • Numbness, tingling, hot or cold feelings, weakness or a heavy and tired feeling in the arms or legs
  • Clumsiness, frequent falling, or a foot-slapping gait

How is spinal stenosis diagnosed?

These symptoms also can be caused by many other conditions, which makes spinal stenosis difficult to diagnose. There is usually no history of neck or back problems or any recent injury. Often, unusual arm or leg symptoms are a clue to the presence of spinal stenosis.

In addition to a complete medical history and physical examination, diagnostic procedures for sciatica may include the following:

  • x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
  • computed tomography scan (also called a CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

Treatment for spinal stenosis

Specific treatment for sciatica will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

To help relieve the symptoms of spinal stenosis, treatment may include:

  • Medications. Sometimes the pressure on the nerves is caused by inflammatory swelling. Nonsteroidal anti-inflammatory medication such as aspirin or ibuprofen may help relieve symptoms.
  • Rest, followed by a gradual resumption of activity, also can help. Aerobic activity such as bicycling is often recommended.
  • Losing weight can also relieve some of the load on the spine.

In such cases where conservative treatment does not relieve the symptoms, surgery may be suggested by your physician to relieve the pressure on the affected nerves.

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