Spinal Stenosis: 8 Things Doctors Want You to Know
- Spinal Stenosis: A Very Treatable ConditionLow back pain continues to be a common ailment for many people. And, in the case of spinal stenosis, it’s one of the primary symptoms. Spinal stenosis refers to a narrowing (stenosis) of the spinal canal or around the spine’s nerves. This contraction presses on the nerves, resulting in pain in the lower back or neck—in case of cervical spinal stenosis. Numbness and tingling down the limbs is also possible. Non-surgical treatments are available and often provide needed relief for patients. In fact, surgery is not the norm, except in severe cases.
Spinal stenosis doctors advise patients to seek a medical examination as soon as regular, ongoing lower back or neck pain presents itself in order to evaluate and treat spinal stenosis.
- 1. “Spinal narrowing can be caused by many things.”Although a common cause of spinal stenosis is osteoarthritis of the spine, it is not the only cause. “Sometimes, people are born with a narrower spinal canal than others, and so spinal stenosis can develop as a result,” says Neel Anand, MD, orthopedic spine surgeon, professor of orthopedic surgery, and director of spine trauma at Cedars-Sinai Spine Center in Los Angeles, Calif. “Other causes include herniated discs, spinal tumors, and other spinal injuries that affect the nerves of the spine.”
- 2. “Symptoms include neck pain, numbness and cramping in the thighs.”Spinal stenosis symptoms usually begin gradually and depend primarily on where stenosis is taking place, according to Dr. Anand. With stenosis in the cervical spine, or neck, symptoms may include neck pain, numbness and tingling in the arm, hands or fingers on the affected side. If in the lower back, known as the lumbar spine, low back pain or cramping in the buttocks or thighs may be present. “It can also develop into numbness, tingling or weakness in the lower extremities
- 3. “Diagnosis is determined through a series of evaluations.”There is no one test or evaluation to diagnose spinal stenosis. “Diagnosis consists of a history of the patient’s symptoms, review of medical history, and physical examination,” says Christopher D. Frendo, DO, board-certified spine surgeon at New York-based Long Island Spine Specialists PC, which operates locations in West Islip, West Hempstead, Commack and Riverhead. “Imaging tests may include X-rays that can reveal degenerative bony changes (spurs), which may narrow the spinal canal and compress nerves. MRI scans can detect compressive lesions including bony spurs, herniated discs, and tumors. They can show where the nerves are being compressed.”
- 4. “Spinal stenosis generally is diagnosed after age 60.”In most patients, spinal stenosis is diagnosed later in life, although there are some exceptions. “Some people are born with congenital stenosis and may present with symptoms earlier in life, such as the third or fourth decade,” says Eric Holder, MD, physical medicine and rehabilitation, and orthopaedics and rehabilitation at Yale Medicine in North Haven, Conn. “Much more frequently, stenosis is degenerative and diagnosed in the sixth and seventh decades. It is estimated that up to 80% of people demonstrate some degree of spinal stenosis above the age of 70.”
- 5. “Treatment begins with lifestyle modifications and medications.”Spinal stenosis treatment begins with a conservative approach to alleviate symptoms. “This includes lifestyle and/or activity modifications, medications, physical therapy, and possibly injections such as epidural injections,” Dr. Frendo says. Medications include short-term use of such nonsteroidal anti-inflammatories as ibuprofen (Advil, Motrin or Aleve), along with analgesics like Tylenol, he adds. “Physical therapy is helpful in learning exercises to build strength and endurance, maintain flexibility, and improve balance,” Dr. Frendo says.
- 6. “Surgery may not be required to treat spinal stenosis.”Spinal stenosis treatment often does not lead to surgery. “Most people do not need extensive surgery for lumbar stenosis and can be treated with simple decompression and not fusion,” says Mark R. McLaughlin, MD, FACS, FAANS, founder of Princeton Brain and Spine Care in Princeton, N.J. “If a doctor has recommended a fusion to supplement the decompression for your spinal stenosis, seek a second or even third opinion. Also, compare the opinions between both orthopedic and neurosurgical spine surgeons.”
- 7. “Certain symptoms are worrisome and need evaluation immediately.”While many spinal stenosis symptoms are uncomfortable and even painful, they don’t require emergency medical attention. However, for a patient with a history of spinal stenosis, there are certain signs and symptoms that need evaluation, according to Adam Shuster, DO, pain management consultant at Pain Management Consultants of Southwest Florida in Fort Myers, Fla. These include profound weakness in one or both lower extremities, saddle anesthesia (those body parts that would touch a saddle become numb), loss of control of bowels or bladder, and intractable and severe pain in the back and/or legs. “Typically, the [symptoms] above would more likely to be acute [sudden] in onset,” Dr. Shuster says.
- 8. “Spinal stenosis may not be inevitable.”While no one can stop aging, there are steps patients can take to keep degenerative conditions like osteoarthritis, which can later result in spinal stenosis, at bay. “Eating a diet rich in colorful fruits and vegetables can provide your body the nutrients it will continue to need for strong, healthy bones,” Dr. Anand says. “Maintaining a healthy body weight and regular, weight-bearing exercise are also bone-strengthening activities that can help stave off spinal degeneration as you age.”
Spinal Stenosis: 8 Things Doctors Want You to Know