Spinal stenosis occurs when the space around your spinal cord narrows and causes pressure on your nerve roots. The main cause is wear-and-tear arthritis (osteoarthritis). As cartilage wears away, bone rubs against bone. This can result in an overgrowth of bone (bone spurs) that intrudes into spinal cord space.
Other causes of spinal stenosis include herniated disks, thickened ligaments, and abnormal growths. Paget’s disease or major trauma to the spine can also lead to spinal stenosis.
When this condition is due to back problems present at birth, it’s called congenital spinal stenosis. You’re more likely to develop spinal stenosis as you age, however. According to the American Academy of Orthopaedic Surgeons, it usually occurs in people over 60 years old.
General symptoms include back pain and numbness or weakness of the legs.
After a physical examination, your doctor will likely want to order some tests to determine the cause of your symptoms. Imaging tests, such as X-rays, MRI scans, and CT scans can provide detailed pictures of your spine.
There is no cure for spinal stenosis, but there are treatments to help relieve symptoms. Over-the-counter anti-inflammatory medications can ease swelling and pain. If they don’t do the trick, your doctor can prescribe higher-dose medication.
Your doctor may also recommend cortisone injections. This anti-inflammatory drug is injected directly into the area of the spinal stenosis. Cortisone can significantly ease inflammation and pain. Its effects may be temporary, however, and you shouldn’t have more than three injections in a single year.
You might feel as though you’re in too much pain to exercise, but movement is crucial to your overall health. Try to perform some stretching exercises several times a day.
If you haven’t exercised in awhile, start slowly, even if it’s only a few minutes a day. Ideally, you should exercise for 30 minutes at least three times a week.
If exercise is particularly difficult, try exercising in a pool. The buoyancy of the water makes it easier to move and get full range of motion.
Regular exercise can help improve flexibility and balance, enabling you to move better. Not only is it good for your physical health, but it can also improve your sense of well-being.
Your doctor or physical therapist can recommend exercises specifically designed to strengthen your back and abdominal muscles. They can also instruct you on how to do them safely. If your condition is severe, you may need a back brace for extra support.
If exercise is aggravating your condition, see your doctor.
Besides regular movement, massage therapy may help loosen up your back muscles and provide overall relaxation. Chiropractic manipulation is another option, but ask your doctor if it’s a good choice for your particular condition.
If nothing else helps and your quality of life is at stake, there are a few surgical options.
Laminectomy (decompression laminectomy)
In this technique, your surgeon makes an incision to access your spine. Then, bone spurs, ligaments, or anything else pushing on the nerves are trimmed or removed. There’s another version of this surgery in which multiple smaller incisions are used. Either way, the procedure gives your spinal cord more space.
Following the procedure, you may be able to go home the same day or the next day.
Discectomy
This procedure is used when part of a disk is compressing spinal nerves. Using a small incision, the surgeon removes the part of the disk causing the problem.
Spinal fusion
The goal of this surgery is to stabilize, or lock two or more bones so they can’t move. This is done with metal hardware or bone graft from your pelvic bone. It may be harder to bend after this procedure, but it’s intended to decrease pain. You may need to stay in the hospital for a few days following spinal fusion.
In a minimally invasive procedure, spacers can be inserted between the spinous processes. This keeps the vertebrae apart and the space open.
Other considerations
These surgeries may not be a cure, and symptoms can come back. As with any surgery, there are some risks. Some of these are infection, blood clots, and injury to the nerve roots.
After any type of back surgery, your doctor may recommend physical therapy for a time. The right exercises can help you gain strength and flexibility.
Though spinal stenosis isn’t always preventable, you have options for dealing with the symptoms. If simple treatments aren’t relieving your symptoms, talk to your doctor about advanced options.