Spinal Stenosis

Spinal Stenosis

spinal stenosis

Spinal Stenosis is a narrowing of the open spaces within your spine, which can put pressure on your spinal cord and the nerves that travel through the spine to your arms and legs. Spinal stenosis occurs most often in the lower back and the neck. (Mayo Clinic)   Spinal Stenosis is an increasingly common issue that chiropractors and other health care providers are seeing in their offices.   It is estimated that in the next decade up to 65 million people will suffer from spinal stenosis. (1)  The reason this condition is becoming more popular is because spinal stenosis is large part a result of spinal degeneration which affect older populations.   As our population continues to age spinal stenosis becomes more prevalent.

What causes spinal stenosis.

Spinal stenosis is all about space.   When bordering structures of the spinal canal start to change from their normal structure space is limited thus causing the stenosis.  The primary factor in developing spinal stenosis is age.   While younger people can have spinal stenosis it is much more common in our later decades.   Arthritis particularly is the leading cause for spinal stenosis.   As our spine ages our discs that are located between each vertebrae for cushioning start to shrink decreasing space.   Ligaments begin to thicken and vertebrae can begin do develop spurs which can start to protrude into the spinal canal.   Both Osteoarthritis and Rheumatoid arthritis can lead to spinal stenosis.   Instability of the spine such as spondylolithesis can also lead to stenosis.   Spondylolisthesis is a condition where one vertebrae will slide anterior in comparison to an adjacent one and it closes down space in the spinal canal.   Lastly tumors and fractures can cause spinal stenosis but they are less likely than the above mentioned causes.

What symptoms can you see.

The most common symptom for spinal stenosis is back pain and pain traveling into the legs.   Pain in the neck can also be seen as well as pain traveling into the arms.   75% of spinal stenosis cases happen in the lower back while the vast majority of the other 25% happen in the neck region.   Other symptoms include pain while walking, numbness and tingling into the feet and legs, weakness into the legs and feet.   Less likely but possible are all the above mentioned symptoms in the arms and hands.   Spinal stenosis is primarily diagnosed after detailed history examination and imaging including X-Ray, MRI, or CT scans.

Options for treatment.

One good thing about spinal stenosis is that the vast majority of cases are slow to develop.   In very rare situations to conditions get significantly worse over a short period of time.   There are exceptions to this especially in traumatic injuries and cases where a tumor may be present.   For the vast majority of spinal stenosis cases conservative care such as chiropractic is recommended before trying surgery.    A recent review found no clear benefits for surgery compared to nonsurgical treatment, a 10-24 percent complication rate with surgery, and no complications with conservative care. (2)  Furthermore the study reported that conservative therapies caused no further complications.   While surgery is an option for these cases it should be an option that is further down the road especially if symptoms appear to be stable.    In our office we use a combination of therapies and treatments including postural corrections, chiropractic adjustments, and decompression.

 

  1. Katz JN, Harris MB. Clinical practice. Lumbar spinal stenosis. N Engl J Med, 2008;358:818–825.
  2. Zaina F, Tomkins-Lane C, Carragee E, et al. “Surgical Versus Non-Surgical Treatment for Lumbar Spinal Stenosis.” Cochrane Library, January 2016.