1. What is Spinal Stenosis?
Stenosis is a Greek word that means “a narrowing”. Spinal Stenosis is a narrowing of the bony structures in the spine. This results from the gradual aging process and wear and tear on the spine and related structures. Spinal stenosis can occur anywhere along the bony spine. In the neck region, it is called cervical spinal stenosis. In the low back region, it is called lumbar spinal stenosis. Spinal stenosis may compress nerves either within the spinal cord (central spinal stenosis) or as the nerves exit the spinal cord (lateral or foraminal spinal stenosis). A very common cause of spinal stenosis is osteoarthritis. Any injury to the spine can cause swelling or inflammation of the nerves and put pressure on them as they run through the spinal cord. Spinal stenosis is a very common cause of both chronic neck pain and chronic low back pain.
2. What are the symptoms of Spinal Stenosis?
Spinal stenosis can cause neck pain, which may radiate down the arms and be associated with numbness and tingling in the arms and hands. It may also cause low back pain, which may radiate down one or both legs. This leg pain is often called Sciatica. Often the low back pain occurs mainly with walking and is relieved with rest or bending forward. This is called neurogenic claudication. This type of pain often develops over many years.
3. How can I tell if I have Spinal Stenosis?
Your primary care doctor or pain management specialist makes the diagnosis of spinal stenosis initially by history and physical exam. When spinal stenosis is suspected, the doctor may order a MRI scan or CT scan. Sometimes a myelogram (a procedure done under x-ray) is necessary to make the diagnosis definitively. Occasionally, plain X-rays or bone scans may be useful as well.
4. What is the treatment of Spinal Stenosis?
Initially, the treatment for spinal stenosis is conservative management. This may include an exercise program prescribed by your doctor or pain management specialist. A physical therapist may be useful to guide your therapy. Mild pain medications such as anti-inflammatories may relieve much of the pain. When conservative measures fail, an epidural steroid injection is the next best step. The epidural steroid injection may be done either in the neck for neck pain due to cervical spinal stenosis or in the low back for low back pain or sciatica due to lumbar spinal stenosis.