If you experience pain in the back after a routine tennis match, or tingling in the legs after golfing, or even numbness in the feet after walking, spinal stenosis might be to blame. Spinal stenosis happens when the space inside the bones of the spine get too small, causing the nerves to become pinched and compressed. Spinal stenosis can cause mild symptoms that some might not regularly notice, but it can also cause others to completely halt their normal activities until conditions improve. Fortunately, the Texas Pain Care team, specialists in Texas, is able to assist patients experiencing low back and neck pain from spinal stenosis in Sugar Land, Missouri City, and Houston areas by providing an accurate diagnosis and the best treatment options for their lifestyle.
Spinal stenosis is the narrowing of one or more spaces in the spinal canal, most often in the lumbar (low back) region and the neck. The narrowing puts pressure on the spinal cord and the nerves that travel through the spine. The compression causes painful nerve and spinal cord impingement.
Spinal stenosis is fairly common, and unfortunately the main cause is age. Most patients who experience spinal stenosis are at least 65 years old. While the spinal column is a strong support structure of the body, due to the fact that there are so many parts that make up the spinal column, there is also an opportunity for a weak link. In between each individual vertebrae in the spine are discs that cushion the vertebrae and provide support. Given the fact that the discs are soft, they can herniate backward, which puts pressure on the spinal cord and adjacent nerves.
Several conditions and injuries can lead to a narrowed spinal canal.
In addition to age, spinal stenosis has many causes that fall into two main groups, congenital (from birth) and acquired (developed after birth). These conditions even have their own pain sensations that a person can feel, then accompanied by the symptoms of spinal stenosis.
Congenital causes include:
Acquired causes are usually due to degenerative changes that come with age. These include:
Bone overgrowth: osteoporosis causes bones to rub together, which can lead to bone growth in the form of bone spurs. When bone spurs on the vertebrae grow into the spinal canal, it narrows the space and pinches the nerves.
Bulging or herniated discs: discs that slip out of place create pressure on nearby nerves.
Thickened ligaments: arthritis can cause the ligaments that hold the spine together to grow thicker, which ends up bulging into the spinal canal.
Fractures and injuries: both broken or dislocated bones, as well as the inflammation related to the break, can lead to narrowing of the spinal canal.
Cysts or tumors: any abnormal growths within the spinal cord and/or vertebrae can narrow the spinal canal.
The pain from spinal stenosis varies from person to person. It can feel like a dull ache or tenderness, while others can experience a burning sensation. The pain can also be intermittent.
Most symptoms of spinal stenosis include:
Many people find that pain worsens when standing for long periods of time, walking or walking downhill, and pain that lessens when leaning forward, walking uphill or sitting. This is because the spinal canal is able to “open up” when leaning forward, which alleviates some of the pressure on the nerves.
A complication of spinal stenosis could be central sensitization, which is when the central nervous system and the peripheral nervous system send abnormal pain sensations to the brain, which causes even the slightest of sensations to feel painful. For those who have severe spinal stenosis and lose feeling in the legs or ability to manage their bowels, immediate emergency care is required.
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The first step in finding the best treatment option is to partner with a trained pain management specialist. They will perform a physical exam, review medical and family history, as well as use imaging tools such as X-rays and MRI to visualize and diagnose the extent of the spinal narrowing so treatment methods can be recommended, starting with the most conservative methods first.
Exercise: specific spinal stenosis exercises and exercise in general can help to both alleviate the symptoms of spinal stenosis and well as prevent the narrowing from happening in the first place.
Alternative therapies: acupuncture, breathing and meditation has proven helpful for relieving pain and stress, which is helpful while other pain therapies are being utilized.
Medications: over-the-counter and prescription medications help patients find relief in the acute phases of the condition.
Epidural steroid injections: a minimally-invasive option, the injection of a steroid and an anesthetic (used to combat pain and reduce inflammation) in placed in the epidural space, which allows patients to more comfortably enjoy physical therapy to find long-term relief.
Percutaneous adhesiolysis: also known as the Racz procedure, adhesiolysis involves removing scar tissue in the epidural space, most often caused by inflammation and irritation.
Spinal cord stimulation: a popular and effective minimally-invasive option for providing long–term pain relief, spinal cord stimulation utilizes a mild electrical current that replaces pain sensations with a tingling sensation. This has proven helpful in a myriad of ways, allowing patients to enjoy an active lifestyle, reduce their need for pain medication, and manage their pain symptoms as needed.
Surgical options: most often used as a last resort, or when medically necessary (i.e. the patient has lost their ability to control their bowels), a laminectomy or foraminotomy involves removing bone or tissue to make more room for the spinal cord and nerves.
If you notice tingling or weakness in your extremities and believe you might have spinal stenosis, or are already diagnosed with spinal stenosis but your treatment options aren’t working, please schedule an appointment with the Texas Pain Care team in the Sugar Land, Missouri City and Houston areas as we are confident we can help you find relief.
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