Spinal Stenosis

Spinal stenosis is the narrowing of spaces within the spine. Stenosis reduces the space nerves have to move through the spinal canal and can cause nerve root or spinal cord compression over time. The condition most commonly occurs in the neck and low back. There are two primary types of spinal stenosis:

• Foraminal stenosis. Intervertebral foramina are bony passageways between vertebrae, through which spinal nerves pass as they exit the spine to other parts of the body. Foraminal stenosis develops when one or more of the bony openings narrows and compresses nerve roots as they pass through.   
• Central canal stenosis. Each vertebra in the spine has an opening in the middle of the bone, through which the spinal cord runs. These openings form the spinal canal, a structure that protects the delicate spinal cord. Central canal stenosis develops when one or more of the bony openings narrows and compresses the spinal cord.    

It’s possible to have both types of stenosis at the same time, and it’s possible to have stenosis in different areas of the spine at the same time. Minimal narrowing may not cause any pain or symptoms, but as the condition progresses, the resulting nerve compression can lead to significant pain, symptoms and weakening. Unfortunately, spinal narrowing cannot be reversed.   

Causes and Risk Factors

Spinal stenosis occurs when age-related changes cause something to narrow the open spaces within the spine. Contributing factors can include:

• Osteoarthritis. Osteoarthritis causes cartilage erosion that leads to pain, swelling and inflammation in the facet joints of the spine. It can also cause the development of bone spurs that grow into the spinal canal and narrow the open space.
• Degenerative disc disease. Spinal discs degenerate naturally with age, wear and tear. When discs become drier and weaker, they start to flatten, which leads to narrowing of the intervertebral foramina between vertebrae. Additionally, degenerating discs may start to bulge outward and push into the spinal canal, obstructing the open space. 
• Herniated disc. Disc herniation occurs when a spinal disc tears and leaks its inner, jelly-like fluid into the spinal canal. The inner material or pieces of broken disc can press against spinal nerves or the spinal cord. Disc herniation can occur from degenerative disc disease or from a sudden traumatic accident that damages a disc. 
• Thickened ligaments. Over time, age, wear and tear cause the ligaments that support spinal bones to thicken and bulge into the spinal canal, obstructing the open space.

Because degenerative spinal changes are the most common reason for stenosis, age is the primary risk factor for developing this condition. Additionally, some people are born with a naturally small spinal canal or a congenital deformity like scoliosis that causes spinal stenosis to develop.    

Symptoms

Some people with spinal stenosis experience no pain or symptoms. Others experience symptoms that start slowly and worsen over time. Symptoms vary depending on the location of narrowing. You may have:

• Lumbar stenosis can cause back pain, and pain that radiates down the buttock and leg (usually one-sided). You may also experience weakness, numbness and tingling in the affected leg and foot. Sciatica is a common symptom of spinal stenosis. It causes one-sided sharp, burning or electric pain that travels from the low back to the buttock, thigh, calf and foot. 
• Cervical stenosis can cause neck pain, and pain that radiates down the shoulder and arm (usually one-sided). You may also experience weakness, numbness and tingling in the affected arm and hand. Cervical spine stenosis can also cause balance problems.  

People with lumbar spinal stenosis often have worsening symptoms like leg pain, cramping and sciatica with long periods of standing or walking. Upright positions place more pressure and stress on the spine. Stenosis pain is usually relieved by sitting and leaning forward, movements that take pressure off the spine and open space for the nerves to move more freely.   

Treatment and Prevention

Spinal stenosis cannot be reversed. The goal of treatment is to reduce pain and symptoms and help you maintain as much movement and flexibility as possible. If you aren’t experiencing any symptoms, or if your symptoms aren’t severe enough that they affect your daily life, your doctor will start by prescribing at-home care and conservative treatment measures. Treatments may include:

• Activity modifications. Pain and symptoms can be relieved by sitting or standing in a forward flexed position. Try using a walker or leaning on a shopping cart during shopping, leaning forward while using a stationary bike for exercise instead of walking, and sitting in a recliner instead of a straight-backed chair.  
• Medications. Over-the-counter pain medications like acetaminophen or NSAIDs can help ease pain and inflammation during times of symptom flare-ups and discomfort. 
• Physical therapy. Physical therapy can help you build up strength in your legs, back and core, increase flexibility and range of motion, and improve your balance and endurance. Your therapist can guide you through exercises and stretches that relieve back pain and pressure. 
• Injections. Corticosteroid injections can help reduce inflammation, irritation and pain around compressed nerve roots and the spinal cord. They’re a temporary solution that can provide pain relief for several months to a year.  

For many people with spinal stenosis, it’s tempting to become inactive when standing and walking causes significant pain. However, remaining active is crucial to managing your condition and preventing muscle weakness and debilitation. Without regular exercise, stenosis gradually weakens the muscles in your legs. Exercises like forward-leaning stationary bicycling or swimming can help you stay active. 

Surgical Options

Surgery is a treatment option if you’re experiencing progressive pain, weakness and numbness that’s affecting your ability to perform daily activities. Decompression surgeries aim to relieve pressure on the spinal cord and nerves and create more space in the spine for nerves to move and function freely. There are several types of decompression procedures and your doctor will talk you through the procedure that’s best for your situation.   

Contact Integrity Spine and Orthopedics to Learn More About the Conditions We Treat

At Integrity Spine and Orthopedics, we specialize in identifying, diagnosing and treating a wide range of acute and chronic back, spine and joint conditions. Our board-certified orthopedic surgeons specialize in performing minimally invasive spine surgeries to reduce pain and improve mobility for patients diagnosed with spinal arthritis, degenerative disc disease, bulging or herniated discs, a pinched nerve, spinal stenosis and more. 

Some of the primary benefits of minimally invasive surgery include:

• Smaller incisions
• Fewer complications and bloss loss during surgery
• Less damage to surrounding muscle and soft tissues
• Lower risk of infection
• Less post-op pain and less reliance on strong pain medications during recovery
• Faster recovery and rehabilitation
• Better cosmetic results with minimal scarring 

If you’re experiencing back or joint pain, weakness, or a loss of mobility, reach out to us today to schedule a consultation with our team. We provide compassionate and comprehensive care to help you find relief from pain and get back to doing the activities you love. 

Call us at 904-456-0017 or contact us online to request an appointment.