The spine is made up of a series of connected bones or vertebrae. These protect the spinal cord or the nerves that send messages to the brain. After a certain age (around 50years), and due to conditions such as arthritis, the spinal canal may begin to narrow in size. When this happens, pressure is felt on the nerves. This condition is known as Spinal Stenosis. ‘Stenosis’ in medical terms refers to an abnormal narrowing of a body channel.
Depending on which area of the spine this affects, there can be different varieties of Spinal Stenosis. Most commonly it occurs in the neck and lower back as these are the areas where maximum movement is present. Spinal Stenosis that occurs in the lower back is known as Lumbar Spinal Stenosis. Spinal Stenosis in the neck is called Cervical Stenosis. Lumbar Spinal Stenosis could cause symptoms of sciatica such as radiating pain and tingling in the lower back and legs. Cervical Spinal Stenosis could cause major problems such as paralysis. Spinal Stenosis could also occur in the middle and upper portion of the spine. Here it is called Thoracic Stenosis. Since there is minimal movement in this region it is rare to see Spinal Stenosis occur here.
The symptoms of Spinal Stenosis can affect a person’s balance. Depending on where the Stenosis occurs, the symptoms could vary. The patient’s motor skills and dexterity may be compromised. It can also affect a person’s grip, bowel movement, functioning of the limbs, gait and balance. Some cases even report a change of handwriting or frequent stumbling and falling. Some people suffer difficulties in carrying out daily activities such as brushing their teeth, getting dressed and buttoning shirts.
In the case of Lumbar Spinal Stenosis, patients experience Neurogenic Claudication. This involves pain, numbness and weakness in the buttocks or legs. These symptoms are usually based on position and some relief is achieved by sitting or bending forward. Sciatica or radiating pain from the lower back to the legs could also be a symptom of Spinal Stenosis. In the case of Cervical Spinal Stenosis the patient may also experience headaches, dizziness and stiffness.
Patients suffering from Spinal Stenosis may not be able to lift their toes, extend their knees, flex their hip joint, a feeling of ‘slapping’ their feet on the ground or standing without difficulty. These symptoms occur because the Stenosis weakens motor signals. Similarly, the patients may suffer a lack of balance because the nerves which sense balance in the lower extremities may be compromised.
It is important to note that Spinal Stenosis does not always display symptoms at the onset. It is a gradual process. Most often you may notice a gradual decrease in physical activity of the patient and the development of a forward stooping posture. The pain is also felt only at certain times and is not continuous. It is for this reason that doctors need to confirm the diagnosis using X-rays, MRIs or CT Scans.
X-rays only show if the structure of the spine is affected. This can be indicative of Spinal Stenosis but an MRI test should be able to confirm the diagnosis and reveal the extent to which the Stenosis has occurred. MRIs can reveal tumors and damage to discs and ligaments. Some doctors also use a CT Scan to confirm diagnosis and rule out other possibilities. The CT Scan can reveal damage to soft tissues.
Some people are born with a smaller spinal canal but for most this is a condition which occurs with ageing. Spinal Stenosis may also be caused due to conditions such as a herniated disc, injury, ligaments that have thickened over time, bones that have overgrown due to spinal diseases, disc degeneration and of course accidents or trauma to the spine.
Spinal Stenosis does not affect everyone. People with a genetic history of back trouble are more prone to develop it. Also people who have subject their backs to greater demands are more likely to get it.
The bad news is that there is no cure for Spinal Stenosis. The good news however, is that there are a number of non-surgical treatments available (such as those at the Spinalogy Clinic) that keep the pain away and allow patients to live completely normal lives.
Some of these non-surgical treatments include physical therapy, exercise and medication. At the Spine Clinic in Pune we will help customize a program to tackle your Spinal Stenosis.
Also, check out: