What is Spinal Stenosis? | Lumbar/Cervical/Lower Back
Spinal Stenosis is a narrowing of a part of the vertebral column that encompasses the spinal cord. This has the potential to put pressure on the spinal cord. Stenosis can also occur in the space through which offshoots from the spinal cord of nerve endings exit the vertebral column. This can place pressure on the nerve endings leading to the extremities. Spinal Stenosis may occur either in the neck or low back, called Cervical Stenosis or Lumbar Stenosis. When this condition is present in the cervical spine, it is considered critical than when it occurs in the lumbar spine because the cervical spine is smaller and there is a greater chance of compression of the spinal cord. It is more common to present as Lumbar Stenosis, however.
What Causes Spinal Stenosis?
The causes of spinal stenosis are many and varied. A thorough evaluation and accurate diagnosis are critical in planning the best treatment strategy for this condition. Some of the causes that can lead to a narrowing of the spinal canal are:
- Age-related changes
- Disc degeneration leading to a collapse of intervertebral disc height or hardening of the disc
- Bone spurs
- Arthritic changes
- Thickening of ligaments
- Previous fracture of the spinal column
- Certain medical condition such as Paget’s Disease which is a chronic condition that causes bones to grow larger and become weaker than normal
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Symptoms of Spinal Stenosis
Spinal Stenosis symptoms vary widely from person to person. Each individual with this condition will present differently which is why an accurate diagnosis is so vital. Symptoms of Cervical Stenosis and Lumbar Stenosis may be similar in some regards, but there are differences that are specific to having this condition in each area of the spine. The symptoms are most commonly experienced bilaterally, meaning on both sides of the body. This presentation can help your doctor form an accurate diagnosis. Symptoms for Cervical Stenosis may include any or all of the following:
- Neck pain
- Weakness, numbness, or tingling in the upper or lower extremities
- Difficulty walking and other problems with balance and gait
- Clumsiness in hands
- Bowel and bladder disturbances may be present in severe cases
Lumbar stenosis symptoms include:
- Lower back pain that worsens with extension of the spine (leaning backwards or straightening up)
- Sciatica symptoms which can involve pain, numbness, tingling, or weakness in the lower extremities
- Complete loss of sensation in feet
- A strength issue of your shin muscle that affects significantly affects walking known as ‘foot drop’
- Sexual dysfunction
- In severe cases, a loss of bowel and bladder control
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Spinal Stenosis Treatment
Both cervical and Lumbar Spinal Stenosis are often successfully treated conservatively without the need for surgical intervention. This will include a course of physical therapy aimed at educating you on proper movements so as not to exacerbate the pain. Physical therapy will also have the goal of strengthening muscles and exercises geared at increasing flexibility and restoring any function that may have been lost. In the case of Cervical Stenosis, often wearing a cervical collar will be required for a time.
A form of spinal decompressive surgery will be recommended in advanced stages of the disease, especially in the case of Cervical Stenosis.