What is Spinal Stenosis?

Spinal stenosis is a medical condition where the spinal canal becomes narrow. This narrowing can put additional pressure and compression on the spinal cord and can cause a pinching of the nerve roots. If the narrowing is in the lower part of spinal cord it is referred to as Lumbar Spinal Stenosis and if the narrowing is in the upper part of the spinal cord then it is referred to as cervical spinal stenosis. While stenosis can also occur in the thoracic or upper back region, the lumbar and cervical areas are the most common.

Who Can Get Spinal Stenosis?

Although some people are born with spinal stenosis, the condition is usually seen in people over the age of 50 who already have some disc degeneration. Often, spinal stenosis results from the wearing down on the spine from normal activities. As we get older, our spinal ligaments can calcify, bone spurs may form, and we can get herniated or ruptured discs. All these conditions can lead to a narrowing of the spinal canal which can compress and pinch the spinal nerves.

Spinal Stenosis Symptoms

Symptoms of spinal stenosis can include back pain radiating to the legs, numbness or pain in the buttocks that worsen when walking or exercising, leg weakness, decreased physical endurance, loss of balance, and leg and neck pain.

Treating Spinal Stenosis

In general doctors tend to take a conservative approach when initially treating spinal stenosis. Drug therapy such as pain relievers and anti-inflammatory medications to reduce swelling are usually prescribed first, along with bed rest and reduced physical activity. Steroid injections can also be use to help reduce swelling although the pain relief is normally temporary. Traction and spinal decompression may be prescribed, along with physical therapy which can be used to help increase flexibility as well as build endurance.

If the pain is acute, then surgery may be needed in order to widen the spinal canal and to correct the conditions that are contributing to the nerve compression. Some of the surgical procedures used to treat spinal stenosis are:

Decompressive laminectomy. This is used for treating lumbar spinal stenosis and involves removing the top of the vertebra to create more space for the nerves.

Laminotomy. This is a partial removal of the lamina which can be done to widen the spinal canal and relieve compression on the nerve roots.

Foraminotomy. Removal of bone, scar tissue, or other obstructions that are compressing the nerve root exiting the spinal canal.

Due to the risks involved, many doctors will resort to surgical treatments only after non-surgical treatments have been tried first.

This article is not meant to replace the sound advice of a personal physician. Patients should discuss with their doctor all their treatment options before taking any medical course of action.

Dan Raymond

Medical science has gone out of its way to promote the idea that degenerative disc disease is some abnormal and harmful condition which typically causes pain and disability in the spines of affected patients.  However, DDD is actually a universal and completely expected part of the aging process and is virtually never the actual source of any significant pain or related neurological symptoms.

The actual words “degenerative disc disease” are incredibly frightening and conjure up visions of spinal dysfunction and agonizing misery.  Most patients diagnosed with the condition are not given an objective and honest view of the real nature of the spinal changes they have experienced.  Instead, many doctors describe in vivid detail how their spines are failing, due to the disintegration of the intervertebral disc structures.  Most often, other diagnoses are made in conjunction to DDD, including foraminal stenosis, osteoarthritis, facet joint syndrome or even discogenic pain.  These pronouncements, just like DDD, represent typical changes in the spinal anatomy and are certainly not inherently painful unto themselves.

Most degenerative conditions generally begin past middle age and typically continue for life.  This is not true for degenerative disc disease, since most people demonstrate considerable degeneration in their lumbar and cervical spines by the age of 30 and many people show these change far younger.  I, for one, was diagnosed with advanced DDD in my lumbar spine at the age of 16.  The idea that DDD is an actual disease is laughable, since it is not harmful, contagious or unusual to experience during a normal human life.  In fact, show me an adult without DDD in their lumbar spine and I will show you an evolutionary anomaly!

If DDD is so innocent and coincidental to the occurrence of back pain, then why is it diagnosed as the source of pain in so many patients?  This is an excellent question and a major inspiration for my writing on the subject of chronic pain.  Degenerative disc disease, like many other back pain scapegoat conditions, is almost guaranteed to be found in the human spine.   It an old standby on which pain can be blamed, simply because doctors know it is there before they even complete any diagnostic testing.  Additionally, the fact that most laymen do not understand DDD makes the condition a perfectly acceptable structural abnormality to target as the villain in otherwise idiopathic back pain syndromes.

Blaming DDD for the kinds of serious and life altering pain conditions inherent to chronic lumbar dorsopathy is like blaming gray hair and skin wrinkles for causing cancer.  It is a ludicrous notion!  How a doctor can pronounce degenerative disc disease as the source of pain, when they themselves demonstrate the condition, just like every other human on this planet, is quite beyond me… That is until you take a long hard look at the profit driven history of the back pain industry and realize how keeping a patient in long term treatment is the real goal of many care providers.  There are few cures for common back pain, although there are hundreds of symptomatic therapy options.  In order for the money to keep flowing, DDD is used as a scapegoat and nothing more…

It is possible, in extremely rare circumstances, for a person to suffer pain from atypical disc degeneration.  This is medical fact and I can not and will not deny it.  However, the chances of this are so slim that less than one half of 1% of all positively diagnosed patients fit this criterion.  The rest are merely chasing a dream, thinking that they will ever achieve lasting relief from treating DDD.  Remember, there is nothing to treat!  Therapy options designed to manage degenerative disc disease are generally unsuccessful, due to the simple fact that the diagnosis is incorrect and the pain is actually the result of another physical, or more likely, psychosomatic process.

Degenerative disc disease is just the tip of the iceberg when it comes to blaming the epidemic incidence of chronic back pain on a structural spinal causation.  The general public has been mislead into thinking that the spine is a fragile and easily damaged structure, when in fact, the spine is a miraculous result of millions of years of targeted evolution.  The human spine is actually the reason why we, as a species, have risen above the rest and proven ourselves to be so successful.  However, this is no surprise, given the Cartesian philosophy embraced by modern medical science.  Doctors look at themselves as engineers of the anatomy, rather than healers who must consider all possible contributors to pain and suffering, including physical, mental, emotional, societal and environmental factors.

In summary, degenerative disc disease is not something to fear.  In fact, fear is a major source of back pain and the nocebo influence of a positive DDD diagnosis will only intensify this occurrence.  If you have been diagnosed, it is crucial to learn the real facts of the condition in order to put yourself on the right road to back pain recovery or else face being led down the wrong path like a lamb to the slaughter…

Sensei Adam Rostocki

Lower Back Pain, affects both those unaccustomed to physical activity and regular exercisers.

The first step to understanding the various causes of low back pain is learning about the normal design anatomy of the tissues of this area. Important structures of the low back that can be related to symptoms there include the bony lumbar spine vertebrae, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area. Many muscle groups that are responsible for flexing, extending, and rotating the waist, as well as moving the lower extremities, attach to the lumbar spine through tendon insertions.

Fortunately, most occurrences of low back pain go away within a few days. Acute or short-term low back pain generally lasts from a few days to a few weeks. Low back pain may reflect nerve or muscle irritation or bone lesions. Most low back pain follows injury or trauma to the back, but pain may also be caused by degenerative conditions such as arthritis or disc disease, osteoporosis or other bone diseases, viral infections, irritation to joints and discs, or congenital abnormalities in the spine. Obesity, smoking, weight gain during pregnancy, stress, poor physical condition, posture inappropriate for the activity being performed, and poor sleeping position also may contribute to low back pain. Occasionally, low back pain may indicate a more serious medical problem.

Nearly everyone has low back pain sometime. The risk of experiencing low back pain from disc disease or spinal degeneration increases with age. Low back pain unrelated to injury or other known cause is unusual in pre-teen children.

A variety of diagnostic methods are available to confirm the cause of low back pain:. Discography involves the injection of a special contrast dye into a spinal disc thought to be causing low back pain. Computerized tomography CT is a quick and painless process used when disc rupture, spinal stenosis, or damage to vertebrae is suspected as a cause of low back pain. Most low back pain can be treated without surgery. Exercise may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles. Medications are often used to treat acute and chronic low back pain. Musculoskeletal pain syndromes that produce low back pain include myofascial pain syndromes and fibromyalgia. Other skeletal causes of low back pain include osteomyelitis orsacroiliitis infections of the bones of the spine.

Most low back pain is triggered by some combination of overuse, muscle strain, and injury to the muscles, ligaments, and discs that support the spine. When low back pain strikes, we become acutely aware of just how much we rely on a flexible, strong back. The causes of low back pain tend to be interrelated. Most people have at least one episode of recurrent low back pain. The term “low back pain” is used to describe a spectrum of symptoms. Depending on the cause, low back pain may be dull, burning, or sharp, covering a broad area or confined to a single point. Leg symptoms can be caused by lower spine problems that place pressure on a nerve to the leg; they can occur on their own or along with low back pain. Your health professional can assess acute low back pain by talking to you about your medical history and your work and physical activities, and doing a simple physical examination. However, some episodes of low back pain are signs of more serious conditions. Low back pain can result from something simple, like cleaning house or lifting a heavy box, or it can be caused by a diagnosable spine condition like a herniated disc or degenerative disc disease.

Effective pain relief may involve a combination of prescription drugs and over-the-counter remedies including BioFreeze. Some type of Lumbar Support is also important for constant support for low back pain. Wonder-Roll which is a self inflating lumbar support pillow is a good solution that you can take anywhere with you.

The vast majority of lower back pain conditions will get better with time and can be addressed with non-surgical treatments, such as osteopathic or chiropractic manipulation, physical therapy, pain medications, etc.. Low back pain responds very well to appropriate conservative treatment such as physical therapy and proper medication which can be prescribed by your physician.

Author: Donna Nocero

Aniruddha Badola

Spinal stenosis is a narrowing of the spinal canal resulting in a lack of space to accommodate the nerves.

The spinal canal contains the nerves that connect to the skin and muscles of the legs. A normal size canal has sufficient space to hold these nerves. But, as a person ages, the canal is subject to narrowing. The narrowing may not always result in problems. But if the narrowing causes pinching of the spinal nerves, problems will develop.

Spinal stenosis isn’t always caused by degeneration due to age. It can also be due to tumors, herniated discs, and injuries resulting from accidents. Spinal stenosis can even be present at birth but this is rare.

The symptoms of spinal stenosis vary depending upon the location of the compressed nerve. If the nerves in your neck or shoulder are pinched, you will experience pain in this area.

If the pressure is on the nerves that control your balance, you will tend to be clumsy or fall easily.

When the stenosis results from a herniated disc, the pain will begin in your hip or buttocks and travel down the back of your leg. In this case, the pain is confined to one side of your body but increases when you sit.

If the pinched nerves are in your lower lumbar region, you can have a condition known as false claudication. People with this problem have pain and cramping in their legs make it difficult to stand straight in one position for long periods of time. Sitting down relieves the discomfort. Walking is easier when bending forward which is why many people with spinal stenosis prefer to shop at stores that have shopping carts. Leaning forward on the cart makes walking much easier. False claudication also makes downhill walking difficult.

There is another form of claudication called vascular claudication, which is a blockage in the arteries in the legs. This also causes pain and cramping but unlike false claudication, it gets worse when walking up hill and gets better when you stand still.

Other symptoms of spinal stenosis are numbness in the arms, hands, feet, or legs and loss of bladder or bowel control. People who experience the numbness need to be careful, as it is possible to injure the body part and not be aware of it due to reduced sensitivity.

Anyone have problems with bowel or bladder control need to consult their physician immediately.

Doctors use radiographs and MRI’s (magnetic resonance imaging) to diagnose spinal stenosis. The radiographs show whether arthritis is present and if there is any slippage of the vertebrae. The MRI scan is needed to detect whether or not there is any pinching of the nerves. There are also special tests available for people who cannot have an MRI.

There are two basic types of treatment for spinal stenosis – surgical and nonsurgical.

Nonsurgical treatments involve physical therapy, anti-inflammatory medication, and epidural steroid injections.

People need to be cautious about the anti-inflammatory medications as many of these have serious side effects. They should be thoroughly discussed with the doctor prior to taking the medications.

The steroid medication is injected directly into the nerve roots within the spinal canal. There are less side effects with this treatment and sometimes it will allow patients to avoid surgery.

The non-surgical treatments are only useful for providing relief from symptoms. They do not decrease the narrowing of the canal.

There are two types of surgical treatments. One, called decompression, consists of removing the bone and soft tissues that are pinching the nerve.

The other involves a spinal fusion during which two or more vertebrae are permanently fused together.

Surgery is usually viewed as a last resort to be attempted when all other treatments fail. However, if there is loss of bladder or bowel control, surgery will be performed immediately.

Brenda Williams

Spinal stenosis is a narrowing of the spinal canal resulting in a lack of space to accommodate the nerves.

The spinal canal contains the nerves that connect to the skin and muscles of the legs. A normal size canal has sufficient space to hold these nerves. But, as a person ages, the canal is subject to narrowing. The narrowing may not always result in problems. But if the narrowing causes pinching of the spinal nerves, problems will develop.

Spinal stenosis isn’t always caused by degeneration due to age. It can also be due to tumors, herniated discs, and injuries resulting from accidents. Spinal stenosis can even be present at birth but this is rare.

The symptoms of spinal stenosis vary depending upon the location of the compressed nerve. If the nerves in your neck or shoulder are pinched, you will experience pain in this area.

If the pressure is on the nerves that control your balance, you will tend to be clumsy or fall easily.

When the stenosis results from a herniated disc, the pain will begin in your hip or buttocks and travel down the back of your leg. In this case, the pain is confined to one side of your body but increases when you sit.

If the pinched nerves are in your lower lumbar region, you can have a condition known as false claudication. People with this problem have pain and cramping in their legs make it difficult to stand straight in one position for long periods of time. Sitting down relieves the discomfort. Walking is easier when bending forward which is why many people with spinal stenosis prefer to shop at stores that have shopping carts. Leaning forward on the cart makes walking much easier. False claudication also makes downhill walking difficult.

There is another form of claudication called vascular claudication, which is a blockage in the arteries in the legs. This also causes pain and cramping but unlike false claudication, it gets worse when walking up hill and gets better when you stand still.

Other symptoms of spinal stenosis are numbness in the arms, hands, feet, or legs and loss of bladder or bowel control. People who experience the numbness need to be careful, as it is possible to injure the body part and not be aware of it due to reduced sensitivity.

Anyone have problems with bowel or bladder control need to consult their physician immediately.

Doctors use radiographs and MRI’s (magnetic resonance imaging) to diagnose spinal stenosis. The radiographs show whether arthritis is present and if there is any slippage of the vertebrae. The MRI scan is needed to detect whether or not there is any pinching of the nerves. There are also special tests available for people who cannot have an MRI.

There are two basic types of treatment for spinal stenosis – surgical and nonsurgical.

Nonsurgical treatments involve physical therapy, anti-inflammatory medication, and epidural steroid injections.

People need to be cautious about the anti-inflammatory medications as many of these have serious side effects. They should be thoroughly discussed with the doctor prior to taking the medications.

The steroid medication is injected directly into the nerve roots within the spinal canal. There are less side effects with this treatment and sometimes it will allow patients to avoid surgery.

The non-surgical treatments are only useful for providing relief from symptoms. They do not decrease the narrowing of the canal.

There are two types of surgical treatments. One, called decompression, consists of removing the bone and soft tissues that are pinching the nerve.

The other involves a spinal fusion during which two or more vertebrae are permanently fused together.

Surgery is usually viewed as a last resort to be attempted when all other treatments fail. However, if there is loss of bladder or bowel control, surgery will be performed immediately.

Brenda Williams

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