Most people get low back pain at one time or another. Low back pain is a symptom of a problem. One common cause of low back pain is a condition called spinal stenosis. .
Spinal stenosis is a narrowing of the spaces in the backbone, or spinal column. This narrowing can cause pressure on the spinal cord or nerve roots.
The spinal column is formed by the bones of your spine, called vertebrae. The vertebrae have a hollow core. When stacked upon each other, they form a canal that protects and supports the spinal cord.
Nerves, called nerve roots, branch off from the spinal cord through spaces between the vertebrae and lead to different parts of your body. With spinal stenosis, the vertebrae put pressure on your spinal cord or nerve roots. Spinal stenosis usually affects the lower back and neck.
There are three ways spinal stenosis can affect your spine. The spinal cord can be squeezed in the spinal canal. The space between vertebrae can get smaller, which puts pressure on the nerve roots. Or the bony canals that the nerve roots pass through can get narrow.
The most common cause of these changes is osteoarthritis. This is the gradual wear and tear on joints as we age. Other causes include injury to the spine, a herniated disk, tumors, certain bone diseases, past spine surgery, and rheumatoid arthritis.
Spinal stenosis causes constant lower back pain when a person stands or walks. Other common symptoms can include weakness and numbness in the legs, often in the calves. This can make it hard to walk more than a few steps. The numbness and pain may go away if you change position and take pressure off the nerve, such as by bending forward. Some people may have a hard time controlling their bowels or bladder.
Your healthcare provider will ask about your medical history and symptoms. He or she will give you a physical exam. You may have imaging tests to look at your spine. These can include X-rays or an M-R-I, which uses magnets and a computer to create images. Or you may have a C-T scan, which uses a series of X-rays put together with a computer.
Treatment for spinal stenosis can include pain medications such as non-steroidal anti-inflammatory drugs, called NSAIDs. These can help relieve pain and swelling. Examples of NSAIDs include aspirin, ibuprofen, and naproxen. Injections of steroids into the spinal canal can also reduce swelling and relieve pain.
Physical therapy exercises that strengthen your back, belly, and leg muscles can help with symptoms. Stretching, massage, and use of a back support may also help. Some people may benefit from acupuncture and chiropractic care.
If you have severe pain and numbness, your healthcare provider may recommend surgery.
The most common surgery for spinal stenosis is called a laminectomy. During the surgery, a part of your vertebra is removed, making more room for the nerves.
Another type of surgery is called a foraminotomy. In this procedure, excess bone and other tissue is removed from the foramen. This is the space in the spine where nerve roots exit. This takes pressure off of the nerve root.
In some cases, bones in the lower back can be fused together with bone grafts.
Things to Remember
- Changing position can help relieve numbness and pain.
- Talk with a spine surgeon about the risks and benefits of surgery.
- Work with your health care team and take an active part in your treatment.
If you don’t have spinal stenosis, keep your spine healthy. Get regular exercise. Practice good posture. And keep a healthy weight to reduce the stress on your back.
What We Have Learned
Spinal stenosis is a narrowing of the spinal canal. True or false?
The answer is True. The narrowing puts pressure on the spinal cord and nerves.
Spinal stenosis most often affects the upper back. True or false?
The answer is False. Spinal stenosis the lower back and neck most often.
Treatment for spinal stenosis includes medication and physical therapy. True or false?
The answer is True. In some cases, surgery may be an option when these treatments do not work.