Overview | Causes | Symptoms | Diagnosis | Treatment | FAQ
Stenosis is a condition that can develop as a person ages, particularly
in those over 50. It is characterized by a narrowing of the spinal canal,
which places pressure on the spinal cord and nerves because there is
not enough room for them. It resembles placing a ring on your finger.
If the finger becomes injured or inflamed, the ring constricts and causes
pain. The pain caused by stenosis is typically focused in the low back
area and can shoot down the legs and flare up after walking or exercising.
Narrowing of the spinal canal may be genetic. However, the primary contributing
factor to the development of stenosis is degenerative disc disease. As
the spine undergoes changes in stability, density and size, this can result
in less space for and more pressure on the spinal structures.
When one area of the spine is injured, it is more likely
that spinal health in other areas will fail. Conditions that may encourage
the development of stenosis include scoliosis, osteoarthritis, rheumatoid
arthritis, spinal tumors and trauma.
Symptoms of stenosis include a deep aching in the low back, buttocks and
thigh, and intense numbness or pain in the legs and sometimes the shoulders.
Symptoms can be brought on by walking and exercise. If you have stenosis,
you may notice that pain is sometimes relieved by sitting or by a position
in which the spine is flexed forward and bending over. Consequently, people
with stenosis may walk with a hunched over posture and find that their
pain worsens when bending backward. Severe cases of stenosis will display
more serious symptoms such as loss of bowel and bladder function and loss
of feeling in an arm/leg.
Outlined below are some of the diagnostic tools that your physician may
use to gain insight into your condition and determine the best treatment
Medical history: Conducting a detailed medical history
helps the doctor better understand the possible causes of your back
and neck pain, which can help outline the most appropriate treatment.
Physical exam: During the physical exam, your physician
will try to pinpoint the source of pain. Simple tests for flexibility
and muscle strength may also be conducted.
X-rays are usually the first step in diagnostic testing
methods. X-rays show bones and the space between bones. They are of
limited value, however, since they do not show muscles and ligaments.
MRI (magnetic resonance imaging) uses a magnetic field
and radio waves to generate highly detailed pictures of the inside of
your body. Since X-rays only show bones, MRIs are needed to visualize
soft tissues like discs in the spine. This type of imaging is very safe
and usually pain-free.
CT scan/myelogram: A CT scan is similar to an MRI in
that it provides diagnostic information about the internal structures
of the spine. A myelogram is used to diagnose a bulging disc, tumor,
or changes in the bones surrounding the spinal cord or nerves. A local
anesthetic is injected into the low back to numb the area. A lumbar
puncture (spinal tap) is then performed. A dye is injected into the
spinal canal to reveal where problems lie.
Electrodiagnostics: Electrical testing of the nerves
and spinal cord may be performed as part of a diagnostic workup. These
tests, called electromyography (EMG) or somatosensory evoked potentials
(SSEP), assist your doctor in understanding how your nerves or spinal
cord are affected by your condition.
Bone scan: Bone imaging is used to detect infection,
malignancy, fractures and arthritis in any part of the skeleton. Bone
scans are also used for finding lesions for biopsy or excision.
Discography - Discography is used to determine the internal
structure of your disc. It is performed with a local anesthetic by injecting
dye into the disc under X-ray guidance. An X-ray or CT scan is performed
to determine if the disc’s structure is normal or abnormal and
if the injection causes pain. A benefit of a discogram is that it enables
the spine surgeon to determine the disc level that is causing pain.
And if surgery is necessary, discography helps ensure a successful surgery and reduces the risk
of operating on the wrong disc.
Injections - These can act as a
bridge to physical therapy by relieving back pain and providing the
physician with important information about your problem.
In many cases, changing posture and using spinal injections can control
the symptoms for a long period of time. Stenosis can be treated nonsurgically,
but some cases require surgery in order to create more space around the
Pain can be relieved by flexing forward and bending over.
Taking anti-inflammatories may be beneficial, especially ibuprofen products
like Advil or Nuprin. Acetaminophen (Tylenol) can be taken for pain, if
you are allergic to ibuprofen. A physical therapy program can be followed
that incorporates stretches and movements that extend the spine. Injections
may be used to reduce inflammation and control pain symptoms. Try our
home remedy exercises provided. Stop if they cause an increase in pain
The most common surgery to treat stenosis is called a laminectomy,
which helps create more space for the surrounding spinal nerves.
What causes spinal stenosis?
Although degenerating discs are the most common cause of spinal stenosis,
spinal tumors, injury, bone disease and other conditions can lead to stenosis
as well. Primary stenosis results from diseases that are
present at birth, while acquired stenosis is typically the result of degeneration
in the spine.
When should I see a doctor?
If pain interferes with your daily activities, you should consult a spine
specialist to treat your stenosis. Leg pain that worsens is especially
an indicator of spinal stenosis. This type of pain is not a normal part
of the aging process.
What should I expect from treatment?
Treatment for spinal stenosis aims at minimizing the effects and symptoms
of the stenosis but does not stop the progression of degenerative changes.
Adopting a healthy lifestyle that includes exercise can help prevent disc
degeneration. Click here to learn more about degenerative disc disease.
When is surgery seriously considered?
If your pain is severe enough or if walking has become difficult, your
physician may consider surgery as an option for you. However, non-surgical,
conservative treatments are usually effective at treating spinal stenosis.
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