The Warning Signs of Spinal Stenosis You Shouldn't Ignore

Spinal stenosis occurs when the spaces between the spine narrow, putting pressure on the spinal cord and nerve roots that branch off it. Spinal stenosis can occur anywhere along the spine, but it is most common in the cervical and lumbar areas of the spine. Cervical spinal stenosis occurs at the top of the spine in the neck and affects the upper extremities; lumbar spine stenosis occurs at the base of the spine and affects the lower extremities.

There is a wide range of symptoms for spinal stenosis, and what symptoms someone has depends on where it occurs. These symptoms may include pain while walking, tingling sensations, pain in the neck, and bladder and bowel dysfunction.

When spinal stenosis occurs in the lower or lumber spine, it can cause pseudoclaudication, which is pain or difficulty walking. This pain may remain in the lower back or radiate down the leg. Physical therapy can help improve this pain by helping to stabilize the spine, increase flexibility, and build endurance. Four to six weeks of physical therapy may be necessary.

Spinal stenosis can also cause numbness and tingling from the pressure on the spinal cord. With cervical spine stenosis, you may feel pins and needles in the arms, hands, or fingers; with lumbar stenosis, you may feel it in your hips, legs, or feet. Stretching exercises can bring relief, particularly flexion exercises that open the spinal canal.

Stenosis in the cervical spine can cause neck pain. This type of neck pain is common in older adults and anyone with osteoarthritis. Wear and tear in the neck can cause bone spurs, which can push into the spinal canal, leading to stenosis in this area of the spine. In addition to pain, this type of stenosis can also cause wrist drop or weakness in the shoulder, arm, or hand.

Some people with spinal stenosis in the lumber spine may experience Cauda Equina syndrome, when the nerve roots are compressed to the point that they cut off sensation and movement to the bowel and bladder. People with Cauda Equina syndrome may experience urinary retention, constipation, or bowel or bladder incontinence. This condition can result in permanent damage if not treated immediately. Even with treatment, some people may not recover complete function.

Symptoms of spinal stenosis may improve when you lean forward as this creates more space between the vertebra and can take some of the pressure off of the spine. Your doctor may ask you to lean forward as part of a physical exam to diagnose spinal stenosis, as this can be a tell-tale sign that someone is experiencing the condition.

Although spinal stenosis pain may never fully resolve, people can experience periods of waxing and waning. For example, pain can worsen when walking or standing for long periods of time but can resolve at rest or when changing positions. During flare-ups, limiting movement can help. Ice packs can also improve pain, but they should only be used for short periods of time. Ice should be applied to the skin for a maximum of 20 minutes and only repeated when the skin is rewarmed, which can take as long as 40 minutes. When using ice therapy, a towel should be placed between the ice pack and the skin to prevent direct contact.

Osteoarthritis is the most common type of arthritis and can lead to disc degeneration or bone spurs that can cause spinal stenosis. This is more common in older adults as osteoarthritis can begin to cause changes in the spine by age 50. While there is no cure for spinal stenosis or arthritis, early detection and management can help prolong function and relieve pain.

Because leaning forward can help relieve the pain from spinal stenosis, it can lead to postural changes. Flexing opens up the spaces in the spine, and it can take the pressure off the nerves. If you need stability when walking, using a walker or cane can help. It can also be challenging to find a comfortable sleeping position with spinal stenosis, especially for people who prefer to sleep on their backs. People with spinal stenosis may find sleeping in the fetal position more comfortable as it opens up the spaces in the spine.

Pain can get worse for people with spinal stenosis when moving from a seated to a standing position; it can be even more painful to get up after lying down, as in first thing in the morning when getting out of bed. There is less pressure on the spine when sitting or lying down, and the added pressure from standing erect can increase pain. Muscles can tighten and stiffen during rest, so once someone with spinal stenosis gets up and moving, this pain may improve. Stretching and doing PT exercises can also help.

Nerve compression from lumbar stenosis can cause [https://www.niams.nih.gov/health-topics/spinal-stenosis)." title="Spinal Stenosis" desc="Symptoms of Spinal Stenosis"]pain in the buttocks. This pain can radiate into the legs and typically worsens when walking or sitting. If you are experiencing persistent pain, it is important to seek medication attention and get a treatment plan that can help alleviate pain and improve quality of life.

Doctors use a number of tools to diagnose spinal stenosis. They may first take an extensive medical history to learn as much as they can about the location and characteristics of your pain and perform a physical exam to determine how your condition is limiting your movements and balance or affecting the reflexes, sensation, and muscle strength in your arms, hands, legs, and feet. Imaging tests can also help determine if you have spinal stenosis. X-rays can show disc and joint degeneration and bone spurs; MRIs can be used to examine the ligaments and nerve roots in and around the spine; and CT scans can be useful for detecting fractures or changes from osteoarthritis.

There are many treatments that may be effective at treating spinal stenosis. Physical therapy can help maintain mobility by strengthening core and back muscles and stabilizing the spine. For people with weak abdominal muscles or older adults with age-related spinal changes, back braces can help provide support.

Some medications may be helpful, including anti-inflammatory medications that can help relieve inflammation and pain, prescription pain relievers, or numbing injections.

Surgery may also be an option for some people with spinal stenosis if nonsurgical interventions are not effective or for those who are experiencing issues with bowel and bladder control or numbness and pain that interferes with walking. Surgical options can include the following:

• Laminectomy: This surgery involves the removal of bony spurs on the vertebra and can help open the spinal column to relieve pressure on the nerves.
• Spinal fusion: In a spinal fusion, a surgeon joins two to more vertebrae that have moved out of position to secure the discs together, closing the space between them.

Newer treatments include interspinous spacers and stem cell therapy. Interspinous spacers is placed during a minimally invasive procedure that blocks the affected part of the spine from extending, preventing spinal compression. Recent research also shows that stem cell therapy may be effective at treating lower back pain, including lower back pain caused by lumbar spinal stenosis, but more long-term studies are needed.

Living with spinal stenosis can be challenging, but some self-care tips can help.

• Get regular exercise. Aim for at least 30 minutes three times a week, making adjustments as needed to avoid making pain worse. Talk to your doctor or physical therapist to get an idea of what specific exercises may help you.
• Pace yourself during the day so you do not overdo it. Make adjustments to your routine as needed so you do not exacerbate pain.
• Use assistive devices as needed to give yourself stability when walking.
• Maintain a healthy weight to avoid putting more pressure on the spine.
• Consult a Medical Professional

If you are experiencing signs of spinal stenosis, consult a medical professional to determine the next steps for diagnosis and treatment.