The spine is divided into three major sections: lumbar, thoracic, and cervical. The spine consists of 33 individual bones called vertebrae. There are five lumbar vertebrae, 12 thoracic vertebrae, and seven cervical vertebrae. Vertebrae are separated by intervertebral discs that act as cushions between the bones. The spinal column is the main support for our body. In addition to protecting the spinal cord from injury, the spinal column allows us to twist, bend, and stand upright. Flexible ligaments and tendons, sensitive nerves, and strong bones and muscles contribute to a healthy spine. If one of these structures are affected by disease, injury, strain, or another medical condition (e.g., spinal stenosis), individuals may experience pain or discomfort.

WHAT IS SPINAL STENOSIS?

Spinal stenosis is a narrowing in a part of the spine. This gradual narrowing reduces the available space for nerves and the spinal cord. While a little spinal stenosis is often painless, advanced cases may lead to weakness, numbness, and pain in lower extremities.

COMMON SYMPTOMS OF SPINAL STENOSIS

The symptoms of spinal stenosis vary from person to person. Some of the common signs include:

  • Pain: Dull or electric-like pain can occur around the neck or lower back regions. The level of pain varies over time and may flare up during certain activities. Sometimes spinal stenosis pain is akin to a pins-and-needles tingling sensation.
  • Numbness: Patients may experience total numbness or reduced sensation in the legs, arms, or other areas of the body.
  • Weakness: Some patients experience temporary loss of coordination or strength in the arms and legs due to spinal stenosis. Severe compression of the spinal cord could also result in bladder and/or bowel dysfunction.

WHAT ARE THE CAUSES OF SPINAL STENOSIS?

In addition to wear and tear, past injuries, and disk rupture (herniation), patients may suffer from spinal stenosis due to:

  • Ligaments in the spinal canal thickening and turning into bony tissue that encroach nearby spinal nerves.
  • Spinal degeneration that causes certain ligaments to be more susceptible to buckling into the spinal canal.
  • Degenerative disc disease that causes discs to flatten, lose hydration, or increase pressure on the facet joints.
  • Spinal osteoarthritis, where smooth cartilage starts to break down, causing bones to rub against each other. This may lead to abnormal bone growth.

HOW TO DIAGNOSE AND TREAT SPINAL STENOSIS

Doctors diagnose spinal stenosis by discussing their patient’s medical histories and performing physical examinations. They may also order imaging tests, e.g., Magnetic Resonance Imaging (MRI), to pinpoint the cause of their patients’ symptoms. MRIs can show which spinal cord nerves are being pressured, detect the presence of tumors, and identify damaged disks and ligaments. If a patient cannot have an MRI, the doctor may recommend a computerized tomography (CT) test. A CT myelogram can help reveal tumors, bone spurs, and herniated discs.

Depending on the severity of the patient’s condition, prescription-strength NSAIDs (nonsteroidal anti-inflammatory drugs) such as Celecoxib (Celebrex) may be used to control or reduce pain caused by spinal stenosis. These drugs are generally safe when used at low doses and over a short period of time. If medications do not alleviate the symptoms, surgery may be used to create more space within the spinal canal to relieve pressure on nerve roots or spinal cord.

WHAT SHOULD YOU DO IF YOU HAVE SPINAL STENOSIS?

Patients with spinal stenosis often limit their activity in order to avoid or reduce pain. Less activity, however, can lead to muscle weakness and increased pain. It is important to see a physical therapist who specializes in postural re-education. This type of physical therapy can help improve posture, increase strength and endurance, maintain spinal flexibility and stability, and improve balance.

As medical problems become increasingly complex, patients may feel overwhelmed. By consulting with an experienced physical therapist, patients can not only regain spinal health but also peace of mind.

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