Spinal stenosis is a narrowing of areas in the lumbar (back) or cervical (neck) spine, which causes pressure on the spinal cord or one or more of the spinal nerves. Often, symptoms will gradually worsen over time and are usually present on one side of the body or the other.
Symptoms can include:
Numbness, cramping or pain in the back, buttocks, thighs or calves, or in the neck, shoulders or arms
Weakness of a portion of a leg or arm
Difficulty or imbalance when walking
Problems controlling urine or bowel movements
Problems urinating or having a bowel movement
Symptoms are more likely to be present or get worse when you stand or walk upright. They will often lessen or disappear when you sit down or lean forward. Most people with spinal stenosis cannot walk for a long period of time.
Some of the most common spinal stenosis causes are:
Herniated disc - When a spinal disc ruptures, the gel-like core leaks out and can cover part of the foraminal opening, decreasing the space through which the nerve root can pass. In most cases, the nerve root can still pass through the opening uncompressed, no symptoms are caused, and stenosis surgery is not needed. However, if the herniated disc does press on the nerve root, symptoms like pain, weakness, tingling, numbness, and more can result.
Bulging disc - Similar to a herniated disc, a bulging disc usually doesn’t impinge upon the nerve. However, if it does push far enough into the foraminal opening, it can compress the nerve root.
Bone spurs - Oftentimes due to arthritis, bone spurs form when cartilage between joints wears away and the bones of that joint rub against one another. To protect themselves, the bones then form protective layers known as bone spurs, which are actually not pointed but are simply enlarged bumps on the bone. If these bumps become too pronounced in the right area, they can cause stenosis.
Swollen ligaments - Usually related to aging, the ligaments in the spine can thicken and stiffen to the point where they put pressure on the nerve root.
Even when your back pain does not go away completely, or if it gets more painful at times, learning to take care of your back at home and prevent repeat episodes of your back pain can help you avoid surgery. Your doctor and other health professionals are partners with you to manage your pain and keep you as active as possible.
Conservative management is most often encouraged. This involves the use of medications, physical therapy, and lifestyle changes. Steroid injections may relieve pain for a period of time.
Various other medications may help with chronic pain but if the pain is persistent and does not respond to these measures, surgery is considered to relieve the pressure on the nerves or spinal cord. Surgery is performed on the neck or lower back, depending on the site of the nerve compression.
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