Spinal stenosis occurs when the small spinal canal containing the spinal cord and the nerve roots becomes compressed. The compression can cause “pinching” of the nerve roots and the spinal cord and can result in cramping, weakness, numbness, and pain. Depending on the location of the narrowing, symptoms can be felt in the legs, lower back, shoulders, arms, or neck.
Typically, the narrowing can be attributed to “wear and tear” arthritis or osteoarthritis. Other likely reasons include bulging of the discs that separate the vertebrae and thickening of the ligaments found in the back. Symptoms of the condition often starts gradually but typically worsens overtime.
Who are at risk?
Spinal stenosis can affect both genders and is observed to be common among those aged between 50 and 70. However, the condition can also occur in young people who have experienced spine injury or who are born with a narrow spinal canal.
For people born with a small spinal canal, the condition is called “congenital stenosis.” For spinal narrowing secondary to age-related changes, the condition is called “acquired spinal stenosis.”
Spinal stenosis can also be attributed to certain medical conditions such as bony spurs, osteoarthritis, spinal tumours, ankylosing spondylitis, and Paget’s disease.
What are some of the common symptoms?
Some of the common symptoms of spinal stenosis include:
Weakness, numbness, cramping, and pain in the feet, thighs, or legs
Abnormal bladder or bowel function
Pain that travels down the leg
Loss of sexual function
Partial or complete leg paralysis (severe cases)
How is the condition diagnosed?
To diagnose and determine the seriousness of the condition, certain test might be recommended, including:
X-ray of the spine – done to check for bone spurs, osteoarthritis, or narrowing of the spinal canal.
Computed tomography (CT) scan – can take detailed images of the back as well as the spinal canal.
Electromyogram (EMG) – done to check the condition of the nerves going to the legs.
Magnetic resonance imaging (MRI) scan – can take pictures of the nerves as well as the spinal cord.
Blood tests, X-rays of the knees and hips, as well as circulation in the legs to rule out other possible conditions with similar symptoms.
What are some of the treatment options available?
In most cases, conservative treatment is the first option considered. However, in cases where the pain is disabling and severe, surgery might be recommended.
Nonsurgical treatment options
Non-surgical spinal decompression therapy – NSSD is considered one of the most effective treatment options for people with spinal stenosis. Computerised and modern machines can help target the areas of the spine and can decompress them to relieve any pressure on the nerves. This treatment option is also considered more potent when combined with other conservative treatment approaches.
Chiropractic – specific spinal manipulation where manual or instrument-assisted techniques are used work by helping the joints return to their normal motion range. Good motion has also been known to help reduce pain, minimise muscle spasms and tightness, and improve one’s overall health. Motion can also help the formation of scar tissue that leads to stiffness is minimised.
Surgical treatment options
Surgery for spinal stenosis may involve removing bony overgrowths so pressure and pinching of the spinal nerves is relieved.
Spinal fusion – for those with spinal instability or slippage, two or more vertebrae may be fused together permanently using screws to give the spine more stability.
Surgical spinal decompression (laminectomy) – in laminectomy, the lamina or the back portion of the vertebra is removed so the nerves and the spinal cord are exposed. Thickened ligaments and bone spurs are also removed.