Spinal Stenosis in the Back

What is it and how is it Treated?

Spinal Stenosis in the Back Spinal stenosis in the back can cause patients to experience a wide variety of symptoms, including localized pain and numbness or muscle weakness in the lower extremities. Those who are diagnosed with the condition are often left with a number of questions, such as, “How did I get spinal stenosis?” and “What should I do now?” The answers to these questions can be found by consulting with a primary care physician or spine specialist.

In some cases, however, an appointment cannot be made until several weeks or even months in the future. Rather than continually worry about their health, these patients may benefit from performing their own research to learn more about their condition. It should be noted, however, that individuals who have been diagnosed with spinal stenosis in the back should only utilize treatments that have been recommended by their own doctor. These individuals should also be aware of the fact that spinal stenosis can have many different causes and can produce many different symptoms. So, what is true of one individual’s case of spinal stenosis is not necessarily true about another’s.

Causes of Spinal StenosisSpinal stenosis, which is simply defined as a narrowing of the spinal canal, is usually caused by anatomical debris that has been created by the natural aging process. As individuals grow older, their spines can begin to break down, causing what we colloquially refer to as a “bad back.” The degeneration of the spine can cause a number of conditions, including:

• Herniated discs• Bulging discs• Spinal arthritis• Spondylolisthesis• Calcification of the ligamenta flava• And others

Each of these conditions can produce debris (such as inner disc material in the case of a herniated disc and bone spurs in the case of spinal arthritis) that invades the spinal canal and causes neural compression. When this occurs in the lumbar spine, the patient is said to have spinal stenosis in the back.

Symptoms of Spinal StenosisIn some cases, patients with spinal stenosis in the back may not exhibit any of the condition’s symptoms. This occurs when anatomical debris has invaded the spinal column, but has not caused compression of a spinal nerve, nerve root, or the spinal cord itself. However, when neural compression does occur, patients can experience a wide range of symptoms, including:

• Pain• Numbness• Tingling• Muscle weakness• A sensation of heat• A pins-and-needles feeling

In most cases, these symptoms can travel along the length of the affected nerve to seemingly unrelated areas of the body. In the case of spinal stenosis in the back, patients can experience discomfort in the lower back, hips, buttocks, legs, and/or feet.

Managing Symptoms with Medication

Many patients who suffer from spinal stenosis in the back are able to manage their symptoms by taking over-the-counter medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen and ibuprofen are typically the medication of choice, as NSAIDs can both relieve pain and reduce inflammation. Patients who are unable to take NSAIDs may instead be advised to take an over-the-counter analgesic such as acetaminophen.

Cryotherapy and Thermotherapy

Though the names of these treatments make them seem unusual, they are actually just exotic words for “cold therapy” and “heat therapy.” Cryotherapy can be administered in the form of an ice pack, ice bath, or other cooling element, and is used to reduce inflammation and numb pain. A whirlpool bath, therapeutic ultrasound, or heating pad can be used during thermotherapy, which aims to relieve muscle tension and muscle spasms. Some patients benefit most from using either cryotherapy or thermotherapy indecently of one another while others achieve optimal results by alternating between the two.

Physical TherapyA number of physicians believe strongly in the therapeutic benefits of physical therapy for patients with spinal stenosis in the back. This type of treatment primarily serves to strengthen the muscles in the back and abdomen to provide the spine with added support and stability. However, physical therapy often employs other treatment methods, including:

• Therapeutic spinal traction• Massage therapy• Transcutaneous electrical nerve stimulation (TENS)• Posture modification exercises• And more

Alternative Therapies

Though not typically directly recommend by a primary care physician or spine specialist, many patients utilize alternative or complementary therapies to manage the symptoms of spinal stenosis in the back. One of the most popular options is acupuncture, or the insertion of small needles into specific points on the body. This is said to scramble nerve signals, in turn relieving pain. Many patients also utilize chiropractic treatment, which serves to adjust, manipulate, and otherwise stimulate and affect the spine and its surrounding muscles to relieve pain. Other common alternative therapies include herbal supplements, acupressure, hypnotism, restorative yoga, and Pilates, among others.

Surgery for Spinal StenosisOnly a small minority of patients who are diagnosed with spinal stenosis in the back will ever need to consider surgical treatment. Conservative, nonsurgical treatments are adequate for most patients with chronic back pain and discomfort, especially when utilized in conjunction with one other. However, those who are advised to consider surgery may want to inquire about their candidacy for a minimally invasive alternative.

Endoscopic spine procedures have gained popularity in recent years thanks to their relatively high success rate, low risk of complications, and brief rehabilitation period. These procedures are performed on an outpatient basis under deep IV sedation and local anesthetic. The surgeon makes a very small incision (usually less than one inch) in the patient’s back and then gently inserts a series of tubes. This allows the surgeon to access the spine without dissecting any musculature, in turn greatly reducing the procedure’s recovery time.

The exact techniques performed during a minimally invasive spine procedure will vary depending on the patient’s underlying degenerative spine condition. In the case of a herniated disc, for instance, the surgeon will vaporize the expelled inner disc material to relieve neural compression. When the patient is suffering from spinal arthritis, the surgeon will use a laser to deaden the affected nerve. This is performed in a similar fashion as a dental root canal. Many other degenerative spine conditions can also be treated with a minimally invasive spine procedure, allowing thousands of patients to experience the advantages of endoscopic surgery.

Learning More

As previously mentioned, patients can only receive individualized information regarding their health by consulting with a physician. Those who wish to learn more about spinal stenosis in the back are advised to make an appointment either with their primary care physician or a spine specialist. Before embarking on any treatment regimen – especially if surgery is recommended – patients may benefit from receiving a second or third opinion. This can ensure the correct diagnosis has been formed and that the optimal treatments are being utilized.