Spinal stenosis

A narrowing of the spinal canal at one or more sites through which nerves pass is known as spinal canal stenosis. The spinal cord or nerves that originate from these narrowed spinal spaces get compressed which leads to pain, cramping and weakness. When standing or walking, a person experiences excruciating discomfort in the legs, calf muscles, or lower back. Walking up or down a slope, ramp, or steps may cause pain to worsen more quickly. Usually, hunching over posture can ease the pain.

Typically "wear and tear" arthritis of the spinal canal between the vertebrae causes narrowing of the spinal column. In addition, bulging of the discs which are present between the vertebrae and thickening of the spinal ligaments may contribute to it.


Symptoms

Symptoms begin gradually and worsen over time. Spinal stenosis symptoms include:

  • Neck pain
  • Leg pain or cramping
  • Tingling or weakness in the hands & legs
  • Numbness
  • Problems with walking and balance
  • Problems with the bowel movements or bladder control.

Most often, the symptoms of carpal tunnel can begin slowly, without any injury. Initially, many individuals experience symptoms that come and go. After a prolonged period, the condition intensifies, and symptoms are seen more regularly or may be able to stay for an extended period of time.

The symptoms of tunnel syndrome at night are common. They may cause sleep problems, as many people sleep with their wrists bent. The symptoms are commonly seen during the daytime when holding anything for a long time (resulting in less grip to hold things) for example, during driving, writing, using a phone, or reading a book.


Causes

The causes of spinal stenosis are multifactorial ranging from congenital or hereditary, traumatic or degenrative , inflammatory or infective or neoplastic pathologies :

Achondroplasia

This genetic disorder affects bone development throughout the body, including the spine.

Congenital spinal stenosis

A birth abnormality known as congenital spinal stenosis forces the spinal canal to be smaller than average.

Aging

Old age is the most common cause of spinal stenosis. The tissues and bones in the spine may begin to thicken in old age, compressing the nerves.

Osteoarthritis

Osteoarthritis : When the protective cartilage that cushions the ends of the bones breaks down over time, it causes this condition. It can affect any joint, it is most typically seen in the hands, knees, hips, and spine(Facet joint arthritis)

Ankylosing spondylitis

Ankylosing spondylitis : This specific form of arthritis affects the spine and results in persistent inflammation, which can encourage the development of bone spurs.

Rheumatoid arthritis

Rheumatoid arthritis : Rheumatoid Arthritis is an autoimmune disease that results in chronic inflammation of the joints and other areas of the body.

Scoliosis

This abnormal spine curving is caused by certain genetic disorders, abnormalities of the nervous system, or unknown factors.

Spinal injuries

Bone fractures or slipped discs may result in vertebrae or bone fragments pressing against spinal nerves.

Spinal tumors

These abnormal tissue growths can form in the spinal canal, where they can cause swelling and alter the surrounding bone.


Prevention

Spinal stenosis is not always evident, given that many individuals may have degenerative changes in their spine as they age. Here are some recommendations for avoiding spinal stenosis:

Exercise regularly : There are many ways that regular exercise might help you avoid spinal stenosis:

  • It helps to keep the spine flexible.
  • Helping people to avoid obesity.
  • Enhancing/Strengthening the muscles that surround the spine.

Stretching : If patients find it difficult to exercise because of other medical issues, one can still prevent spinal stenosis by doing safe exercises. Stretching not only helps to reduce stiffness but may also help to have a wider range of motion.

Maintain good posture/Sitting ergonomics : Always maintain proper posture while sitting, standing, or walking, especially if people spend a lot of time in one position. Avoid lifting heavy objects.

Maintain a healthy weight : Being overweight puts additional strain on the body's structures, especially the spine. One may keep a healthy weight by eating a balanced diet, abstaining from excessive alcohol use, and engaging in regular exercise.


Diagnosis

The doctor will comprehensively conduct a physical examination, including weakness, pain, and unusual reflexes symptoms. Imaging tests will be carried out to examine the spine, confirm the diagnosis and determine the seriousness of the condition. These include:

X-rays

X-rays : An X-ray of the spine is done to examine for bone spurs, injuries ,degenerative changes, and narrowing of the spinal canal.

MRI

MRI : MRI images provide detailed pictures of the nerves, disks, spinal cord, and the presence of any tumors.

CT or CT myelogram

A computed tomography (CT) scan is a combination of X-rays that creates cross-sectional images of the spine. A CT myelogram adds a contrast dye to see the spinal cord and nerves more clearly.

Treatment

The severity of the symptoms will determine how you will be treated for spinal stenosis.

First-line treatments

The doctor will probably begin by prescribing medications to treat spinal stenosis, including cortisone injections to lessen swelling. NSAIDs or nonsteroidal anti-inflammatory medicines to reduce pain. Physical therapy helps the muscles regain lost strength.

Surgery

The doctor might advise surgery to relieve spinal stenosis problem if you have excruciating pain or weakness.
Spinal stenosis is treated surgically using various techniques:
Laminectomy surgeries are performed the most frequently. A surgeon cuts away a part of the vertebrae to give the nerves more space.Foraminotomy - the spine section from which the nerves protrude can be widened.
Spinal fusion is frequently done when multiple spine segments are affected, especially in more severe instances. The affected spine bones are joined together using bone transplants or metal implants.


Dos and Don’ts

Spinal stenosis is narrowing of the spinal canal causing compression of nerves. It results in numbness, low back pain and sciatica. Diagnosis includes physical examination and imaging tests.

Do’sDon’ts
Consult the ExpertsLift heavy weights
Follow Medications and Physiotherapy advice strictlySelf neglect and Skip/Avoid doctor consultation
Maintain a healthy weightSelf medicate
Pay attention to good posture/ErgonomicsObesity/Sedentary lifestyle
Consume calcium-rich foodsEating unhealthy/junk foods

Spinal stenosis treatment includes medications, physiotherapy and surgery. Preventive methods are maintaining healthy weight, avoiding injuries and maintaining a proper posture while sitting, standing, or walking.


Care At Medicover

At Medicover Hospitals, we have the best team who provide honest and precise treatment. Our doctors employ the most up-to-date medical treatments, diagnostic methods, and other technologies to treat various musculoskeletal conditions. Our surgeons work with the latest technologies in a multi-disciplinary and state-of-the-art hospital set-up. This allows the patients to receive the best possible care for their conditions.

Citations

https://www.niams.nih.gov/health-topics/spinal-stenosis
https://spinesurgeons.ac.uk/Spinal-Stenosis
https://www.sciencedirect.com/topics/neuroscience/spinal-stenosis
https://radiopaedia.org/articles/spinal-stenosis-1
https://www.nm.org/conditions-and-care-areas/orthopaedics/spinal-stenosis
https://www.templehealth.org/services/conditions/spinal-stenosis

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Frequently Asked Questions

1. What is Spinal Stenosis?

A medical issue called spinal stenosis causes your spine's gaps to close up, which can put pressure on the nerves that run through it. It often occurs in the neck and lower back, leading to symptoms such as pain, numbness, or muscle weakness.

2. What Causes Spinal Stenosis?

Spinal stenosis is often caused by age-related wear and tear, specifically osteoarthritis. Other causes can include spinal injuries, herniated disks, thickened ligaments, and in some cases, tumors or congenital defects.

3. What Are the Symptoms of Spinal Stenosis?

Symptoms can vary from person to person, but common symptoms include pain, numbness, muscle weakness, and tingling in the affected area. Some people may experience difficulty walking or balancing.

4. How is Spinal Stenosis Diagnosed?

Diagnosis typically involves a physical examination, review of medical history, and imaging tests such as X-rays, MRI, or CT scans. These tests help confirm the diagnosis and rule out other potential issues.

5. What Treatment Options Are Available?

Treatment often starts with conservative approaches such as medications for pain relief, physical therapy, and corticosteroid injections. Surgical options like laminectomy or spinal fusions are considered for severe cases.

6. Can Spinal Stenosis Be Cured?

While there's no cure, symptoms can often be effectively managed through treatments. Surgery can offer long-term relief for many people, but it may not be suitable for everyone.

7. Is Exercise Safe for People with Spinal Stenosis?

Exercise can be beneficial, but it's crucial to consult your healthcare provider for a tailored exercise regimen that won't exacerbate your symptoms. Physical therapy can be particularly helpful.

8. What Risks Are Associated with Spinal Stenosis Surgery?

As with any surgery, there are risks including infection, nerve damage, and complications from anesthesia. The success of the surgery also depends on various factors including the skill of the surgeon and the severity of the stenosis.

9. Will I Need to Stay in the Hospital After Surgery?

The length of your hospital stay depends on the type of surgery performed and your general health. Many patients go home within a few days, but complete recovery can take weeks or even months.

10. How Can I Prevent Spinal Stenosis?

While you can't prevent age-related spinal stenosis, lifestyle choices like maintaining a healthy weight, regular exercise, and good posture can help manage or delay the onset of symptoms.