When spinal spaces narrow in certain areas, such as the backbone and supporting nerves, it’s referred to as spinal stenosis. Often affecting the lower back and neck, the condition can be a source of localized pain or discomfort felt in nearby areas (radiculopathy) if nerves traveling through the affected area are compressed. When pressure is placed on those nerves, there’s usually some degree of pain, which is often triggered by certain movements. Stenosis of the spine can be caused by a deformity present at birth, an injury, or age-related spinal changes or wear (degeneration). Here are some crucial facts you should know about spinal stenosis.
Aging Isn’t the Only Cause
Most common in people over 50, spinal stenosis can have many causes, including injury to the spine. People can also be born with narrower spinal canals. Some of the rarer causes of spinal stenosis include:
- Excessive fluoride in the body
- Calcium deposits on ligaments
- Traumatic spine injuries
- Tumors on the spine
It Can Affect Any Part of the Spine
While common in the lower back, spinal stenosis can occur anywhere along the spine. It’s especially serious if the narrowing is relegated to the neck area, referred to as cervical stenosis. Thoracic stenosis, affecting the middle and upper portion of the spine, is less common, since this is the strongest area of the back.
Some Patients Respond Well to Alternative Treatments
Anti-inflammatory medications, physical therapy, and modification of activities are the most common treatments for spinal stenosis. However, you may be among those who respond well to alternative treatments such as acupuncture and herbal remedies. You may also experience relief from:
- Improving your posture
- Limiting alcohol consumption
- Wearing low-heeled shoes
Spinal Stenosis Symptoms Often Appear Over Time
Unlike most common sources of back pain, spinal stenosis often progresses slowly. For instance, people born with the condition may not have any symptoms until they get older or never at all. Subtle symptoms associated with spinal stenosis can include:
- Increased instances of pain while standing or walking
- Experiencing relief when in a flexed-forward position
- Pain of varying intensity that comes and goes
Diet May Play a Significant Role in Pain Management
Unless there’s an urgent medical need, spine surgery for spinal stenosis is usually unnecessary. Many patients experience relief from watching their weight and eating foods like green leafy veggies and fatty fish that naturally reduce inflammation. Drinking plenty of water also minimizes pain by keeping the spinal discs hydrated.
3 Standard Categories of Spinal Stenosis
1. Foraminal Stenosis
Sometimes called lateral spinal stenosis, foraminal stenosis is the most common type of spinal narrowing. With foraminal stenosis, cervical disc space is usually narrowed, although the lumbar (lower) spine is sometimes affected. Specifically, it affects side holes that nerve roots travel through (neuroforamen) in the back of the spine.
Contributing conditions such as degenerative disc disease or facet joint arthritis may result in the formation of bone spurs that trap nerves. Typically, patients with foraminal stenosis experience noncontinuous pain that develops over time. An MRI or CT scan with a myelogram (using contrast dye) usually confirms this type of stenosis as the source of pain and related symptoms.
2. Central Canal Stenosis
Often caused by arthritis of the spine, central canal stenosis affects an area around the spinal cord known as the thecal sac. If the spine narrows in this particular area, this spinal component may be compressed as well. Sometimes, a group of nerves at the end of the spinal cord (cauda equina) become irritated or compressed because of central canal stenosis. Nerves within the thecal sac itself may also be affected.
Additionally, herniated or bulging discs could contribute to this type of stenosis, as can any injury or deformity that throws off alignment in the passageway surrounding the spinal cord and nerve roots. Diagnosis usually involves a physical exam and results from image tests. Bone scans and blood tests may also be done to determine if central canal stenosis is what’s causing the symptoms. Treatment may include a surgical procedure such as a lumbar foraminotomy. Los Angeles patients should consult a spine specialist for expert advice about proper diagnosis and treatment.
3. Far Lateral Stenosis
When spinal narrowing goes beyond the neuroforamen, the result is what’s termed far lateral stenosis, which specifically refers to narrowing affecting the side of the neuroforamen. Far lateral disc herniations, which account for about 7 to 12 percent of all disc herniations, in this area sometimes worsen the narrowing enough to trigger disruptive symptoms. Other factors contributing to pain that may be experienced with this type of spinal stenosis include:
- Bone spurs related to bulging discs
• Facet joint problems
• Ligamentum hypertrophy (enlargement of a type of connective spinal tissue)
If spinal stenosis isn’t causing you any significant discomfort, periodic observation may be all that’s necessary. However, if you’re experiencing muscle weakness, limited mobility, local and traveling pain, and other disruptive symptoms, treatment may involve over-the-counter and prescription medications, low-impact exercises, massage therapy, and other forms of therapeutic physical therapy. If symptoms persist, various stabilization and decompression procedures can be performed, often with less invasive techniques.
With early diagnosis, spinal stenosis can often be managed quite well with conservative treatment methods. If you suspect you may have spinal stenosis, don’t wait until your pain is severe—see a Los Angeles spine surgeon as soon as possible. The industry-leading spinal health experts at The Spine Institute are experienced in treating every aspect of spine health. Call one of our friendly staff today at 310-828-7757 to schedule a consultation.