What is Spinal Stenosis
An Overview of Spinal Stenosis
Spinal stenosis. You may have heard the term before. From the name you know it has something to do with the spine. But what is it? As a general explanation, spinal stenosis is the narrowing of the spaces within the spine. This narrowing can happen in the space in the middle where the spinal cord runs, known as the central canal. It can also happen in the spaces where the nerves leave the spine to innervate the rest of the body. This narrowing can put pressure on the spinal cord and the spinal nerves. Spinal stenosis is more common in the neck and in the low back. This blog post will explore spinal stenosis in the low back known as lumbar spinal stenosis.
Lumbar spinal stenosis (LSS) is characterized by significant pain in the legs, calves and/or low back when standing or walking. LSS is a leading cause of pain, disability, and loss of independence in people over the age of 65. As the Canadian population ages, it is estimated that over 3 million Canadians will suffer from LSS in the next 15 years.
What Causes Spinal Stenosis?
Spinal stenosis is most often due to age-related changes that occur over time. In this case, it is considered acquired spinal stenosis. These age-related changes are in fact arthritic-changes, in particular osteoarthritis (OA). OA refers to degeneration of joints in the body. With age, joints in the spine, the facet joints, degenerate similarly to other joints such as the knees and hips. To compensate for the degeneration, our body may produce more bone in the form of spurs. These spurs can take up space leading to compression of the spinal cord or spinal nerves. This is one possible contributing factor to spinal stenosis. In the spine, we also have intervertebral discs between each level. These discs can also degenerate with loss of water content over time. As we get older, discs dry out and lose their strength. Discs begin to shrink in height and disc space is lost. This means that the space where the spinal nerves exit becomes smaller contributing to spinal stenosis.
It is important to note that many people with mild lumbar spine stenosis do not experience any symptoms.
Spinal stenosis can occur from birth in some individuals, however, this is much less common. These people are born with a smaller than normal spinal canal. This is known as congenital spinal stenosis.
What Are the Symptoms?
Symptoms of spinal stenosis, particularly in the lumbar spine can vary from one individual to another. However, more common symptoms include:
- Low back pain – people with LSS may or may not have back pain. This depends on the degree of degeneration and the areas of affection.
- Numbness, weakness, cramping, and/or pain in the buttocks, legs, and feet.
- In severe cases of LSS, loss of bladder and bowel control is possible.
Symptom severity tends to increase with walking, standing up straight, or leaning backward. The symptoms may improve with sitting or leaning forward.
How is Spinal Stenosis Managed?
There is no specific cure for spinal stenosis, however, symptoms can be managed to maintain mobility and independence and decrease pain. It is recommended that conservative care options are used as the first line of treatment for spinal stenosis. In most cases, this is before considering surgery. These conservative care options include a specific exercise program, manual therapy such as chiropractic, massage therapy, and physiotherapy. Although nonsurgical treatment methods do not improve the narrowing of the spinal canal, many patients experience relief in symptoms, increased strength, and improved mobility.