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Spinal Stenosis: Diagnosis, Treatment, and Lifestyle Modifications

 Spinal Stenosis can affect any part of the spine. Stenosis in the upper spine (neck) is referred to as cervical spinal stenosis, and lumbar spinal stenosis if the condition develops in the lower back. It is caused by the narrowing of the spinal canal, resulting in excess pressure being applied to the nerves and spinal cord.

Spinal stenosis can develop naturally as a person gets older or is caused by a degenerative disease such as spondylosis or a herniated disc. A serious injury or an infection can also cause the condition. The symptoms vary, with some people experiencing mild discomfort, while others can suffer from chronic pain.

In this article, we will outline all you need to know about spinal stenosis, including its diagnosis, treatment, and possible lifestyle modifications.

Understanding Spinal Stenosis

Lumbar spinal stenosis (the lower back, L3 to L5 spinal levels.) is more commonly found in people over the age of 60. In its early stages, the condition can cause pain and a pinching/ cramping sensation in the legs. This discomfort can be worsened when the individual is standing, walking, or generally being active. Other symptoms can also include weakness, numbness, and a tingling sensation. 

Stenosis is often linked to spondylosis which is a degenerative condition that can cause:

  • The facet joints can become enlarged as they degenerate, causing compression. These joints sit between each vertebra and enable movement. 

  • The spinal discs are soft tissue that sits between each vertebra, absorbing any shock when a person moves to avoid damage to the bones. These discs are almost jelly-like and over time they can become dehydrated, increasing the chances of a rupture. This is known as a herniated disc and when this tissue ruptures from its protective outer layer it can come into contact with nerves and the spinal cord.

  • Bone spurs can form over the years which are misshapen, spiky bone mutations, and in some cases, this can limit available space in the spinal canal.

  • The ligaments in the spine can also become thicker, reducing the amount of space in the spinal canal.

Spinal Stenosis: Symptoms and Diagnosis

The most common spinal stenosis symptom is pain in the legs when walking, impairing a person’s ability to maintain an active lifestyle. Typically, a person who has spinal stenosis does not experience symptoms when they are resting and the pain will subside when they sit down or lean forward. 

If left untreated, the symptoms will develop and the pain level could increase to almost unbearable levels. This is why it is extremely important to arrange an appointment with your doctor as you as you experience any of the symptoms listed in this article.

Spinal stenosis symptoms often include:

  • Pain that travels down the lower back, into one buttock, and down one leg (sciatica). 

  • A tingling sensation in the lower back, buttock, and leg.

  • Weakness or numbness in the lower back, buttock, and leg.

  • Pain in both legs when walking or standing for long periods.

  • Possible impairment of a person’s coordination and gait balance.

You will likely be given a physical examination by a medical professional to diagnose the condition, and in some cases, you may require an X-ray or CT scan.

Spinal Stenosis: Progression

In rare cases, spinal stenosis can lead to serious issues such as chronic pain, a loss of bladder or bowel control, and progressive weakness in the legs. A doctor will initially recommend a range of treatments before surgery is considered but this process may be accelerated if symptoms are particularly severe.

Treatments and Lifestyle Modifications

The patient will be recommended a range of treatment options to consider, ranging from medication and physical therapy to simple lifestyle modifications. Should a person with spinal stenosis show no improvement over a few months, surgery is likely the next step. For people aged over 65, spinal stenosis is one of the most common reasons for undergoing surgery. 

Initial Treatments

  • Medication: Painkillers, non-steroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants

  • Physical Therapy 

  • Gentle exercise such as swimming twice a week

  • Dietary changes to avoid inflammatory foods and to lose weight

  • Heat or ice packs

  • A back brace

People can also experience significant improvements by altering how they sleep. This could involve changing from your usual sleeping position to avoid lying on your stomach, investing in an ergonomic mattress and pillows, and using mobile apps that focus on aiding sleep, relaxation, and meditation. 

Alternative Treatments

Invasive Treatments

  • Painkilling Injections such as an epidural steroid injection

  • Surgery

Surgery is a last resort and would only be recommended to people who have shown no response to treatments and are suffering from severe spinal stenosis symptoms.

Spinal Stenosis Surgery

A laminectomy is the most common form of spinal stenosis surgery, removing a small part of the vertebra (the lamina) to create more space in the spinal canal. This usually solves any compression issues and stops any impingement on nerves or the spinal canal. 

However, if the issue is related to a herniated disc then a discectomy is likely to be the preferred procedure. This involves removing the part of the disc that is protruding from its outer shell. Both these surgeries can potentially be combined with spinal fusion. This procedure fuses the affected vertebrae, often using metal rods, screws, and a bone graft to provide long-term stability in the spine. 

As an alternative to spinal fusion, individuals who have had a laminectomy or discectomy may consider a spinal stenosis surgery implant. These mechanical implants effectively mimic the natural movement of the vertebrae to maintain full mobility while also providing the necessary strength to support the spine. The recovery time after installing a spinal implant is often quicker than spinal fusion. Furthermore, a spinal device is less likely to cause damage to adjacent vertebrae.

Thank you for reading. If you are suffering from spinal stenosis then we wish you a speedy recovery.

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