Spinal Stenosis and its Symptoms

Spinal stenosis is a condition in which the narrowing of the spinal column compresses the spinal cord. As the space around the spinal cord narrows, the constriction causes increased pressure on spinal nerve roots, leading to pain, numbness, and trouble with balance. The two main types of spinal stenosis are cervical stenosis and lumbar stenosis. Cervical stenosis refers to narrowing in the neck, whereas lumbar stenosis, the more prevalent type, refers to narrowing in the lower back.

Causes of Spinal Stenosis

Individuals born with a narrow spinal column have what is know as congenital spinal stenosis. However, most people experience spinal stenosis as a result of wear-and-tear, herniated discs, or other conditions that affect the spinal canal. Common conditions that may lead to spinal stenosis include:

• Scoliosis Irregular curvature in the spine often leads to degenerative symptoms that affect the lumbar spine.
• Osteoarthritis:The wearing down of protective cartilage in the spine can prompt the formation of bone spurs growing into the spinal canal.
• Paget’s Disease:A chronic disorder that can result in enlarged or misshapen bones in the spine.
• Thickened Ligaments:The ligaments that help hold the spine together can thicken over time and bulge into the spinal canal
• Aging The natural aging process can cause the flattening of the spinal discs over time, resulting in a gradual narrowing of room for the spinal nerves and often leading to herniated discs
• Herniated Disc Spinal discs are soft and rubbery, acting as shock absorbers for the spine. When the soft inner disc material leaks through cracks in the disc’s exterior casing, the inner fluid escapes and puts pressure on the nerves and spinal cord.
• Spinal Injuries: Trauma from car accidents or other injuries can dislocate or fracture spinal vertebrae. Damaged bone can affect the spinal canal and nearby tissue swelling can cause excess pressure on the spinal cord.
• Abnormal Growths:Though uncommon, tumors can grow inside the spinal cord, in membranes covering the spinal cord, or even in the space between the spinal cord and vertebrae.

Treatment

CNS, our team of integrated health professionals offers a variety of treatment options for spinal stenosis, from physical therapy to spinal fusion surgery. We recognize that many patients are nervous about the prospect of spinal surgery and we can recommend several non-invasive treatment options that could prevent the need for surgery. At Coastal, we offer the following spinal stenosis treatment options:

• Physical Therapy and Exercise: Rehabilitative therapy, including stretching, flexing, and strengthening exercises can help open up the spine, strengthen the back, and reduce pressure on spinal nerves. Manual therapies, range-of-motion exercises, and aerobics are often used as part of a comprehensive treatment plan to reduce pain caused by spinal stenosis. Daily at home exercises and remaining active can help with maintaining weight, which reduces stress on the spine as well. For more information about our in Office Physical Therapy department and its therapist click here.
• Epidural Steroid Injections: Corticosteroid injections are provided for patients who have found little to no pain relief from NSAIDs and other non-invasive treatment options. The epidural steroid injections reduce inflammation, temporarily providing pain relief.
• Minimally Invasive Spine Procedures: Using advanced techniques, our spine surgery experts perform minimally invasive procedures that that offer feaster healing times and reduce the risk of damage to surrounding tissues. Minimally invasive spine procedures are effective for treating conditions such as Degenerative Disc Disease, herniated discs, and lumbar spinal stenosis.
• Lumbar Micro Decompression Surgery: Also known as a lumbar microdiscectomy surgery, this involves accessing the spine through a small incision to remove the portion of a herniated disc that is causing irritation.
• Cervical and lumbar fusion surgery: Using metal screws and rods, or a patient’s own bone graft, two or more vertebrae are fused together to improve stability in the spine. Spinal fusion surgeries are effective at relieving pain caused from degenerative disc disease, herniated discs, and fractured vertebra

What to Expect

At Coastal Neurosurgery & Spine we want each patient to feel comfortable and informed at every step of the treatment process. Before treatment, your doctor will review your medical history, diagnostic results, and current medications. This minimally invasive outpatient procedure generally takes between 15-45 minutes. We do recommend that patients make arrangements for transportation, as recovery time may be needed.

Patients are required to lie on an x-ray table to allow the physician to clean the area of injection and administer a local anesthetic. Little to no pain is felt, but patients often feel slight pressure upon needle insertion. Using live x-ray fluoroscopy allows the doctor to view the needle insertion on a monitor. Contrast dye is injected to confirm medication delivery flow location, followed by the injection of the epidural steroid solution.

Depending on the condition and symptoms being treated, the epidural steroid injections may be inserted at different locations. The most common ESIs are cervical and lumbar. Cervical injections are administered just above the nerve root to relieve pain in the neck or arms. Lumbar injections are administered a nerve canal in the back to relieve lower back and and leg pain.

Pain relief effects last for 3 months on average. It’s important to schedule follow-up appointments with your spine specialist at CNS to discuss efficacy of treatment and whether or not to schedule additional injections.

What Causes SI Joint Dysfunction?

• Too much mobility (hypermobility or instability) will cause the pelvis to lack stability and pain will be felt in the lower back, hip and even the groin area.
• Too stiff (hypomobility or fixation) and the pelvis will feel tense, painful and may limit your mobility. The pain in this scenario will likely lead to pain in the side of the low back, buttocks or even pain down the back of the leg, feeling very similar to sciatica pain.

When inflammation occurs in the joint, it can lead to these problems. Women who have recently been pregnant are more susceptible to sacroiliac joint dysfunction. Young and middle-aged women are the most common to struggle with SI joint pain.

Treatment Options for SI Joint Pain

In most cases, there is more than one treatment—but not all treatments are created equal and may not work without side effects. Some doctors resort to surgery and medications without trying non-invasive approaches first. Here at Coastal Neurosurgery & Spine, we start with treatment strategies that promote natural healing and pain relief.

• Physical Therapy: Certain movements, exercises, and stretches can help improve the mobility and strengthen the surrounding muscles and ligaments to help support the SI joint. Your Coastal provider can help you know what movements will most help your condition.
• Radiofrequency Rhizotomy: This nonsurgical procedure stops the pain with heat by “burning” the nerve causing the pain. This interruption can provide some much-needed relief during the healing process.
• Injections: We use injections, like epidural steroid injections, to help reduce inflammation and allow healing to occur. This is a fast-acting pain relief method that should only be used with other therapies to actually address the cause of the pain.
• Minimally Invasive Surgery: While we never turn to this as our first option of treatment, our spine surgeons will certainly consider minimally invasive joint pain surgery as a potential treatment option. We want to have every helpful option available so each patient is treated with an individualized plan that works best for them.
• Sacroiliac Joint Fusion: Typically our last option, we only suggest SI joint fusion if the other joint pain treatment options aren’t working as desired. The fusion stops the movement in the joint, reducing the pressure causing the discomfort.

If you are struggling with lower back pain that radiates into your legs or groin, you should see a chiropractor today to treat the underlying cause. The sooner you get started, the sooner you can find relief and stop things from getting worse. Adjustments and other therapies have brought relief to many of our patients within just a few visits. We want to help you find a solution that gets you back to feeling great again. Call us now to schedule your Coastal Neurosurgery and Spine consultation!