Spinal stenosis is a common condition that results from a narrowing in one or more areas of the spine, usually the neck or lower back. This narrowing can squeeze the nerve roots and spinal cord inside the spinal canal, causing severe pain and disability.
When spinal stenosis affects the neck, it can cause symptoms such as:
- Pain in the neck or shoulders.
- Numbness, weakness, or loss of coordination in a leg, foot, arm or hand.
- Loss of bowel or bladder control.
When spinal stenosis affects the lower back, it can cause symptoms such as:
- Pain or cramping in the lower back, legs, or calves. Usually this pain develops quickly while walking or standing for long periods of time, and subsides after you sit down or lean over.
In people over age 60, spinal stenosis of the lower back is the most common indication for surgery. As many as 400,000 older Americans may have spinal stenosis of the lower back, and this number is expected to rapidly increase as members of the Baby Boom generation enter retirement.
Spinal stenosis is usually caused by osteoarthritis of the spinal column, which most often affects people over age 50. But the condition also can affect younger people who are born with a narrow spinal canal or suffer a spine injury.
Other causes of spinal stenosis include:
- Disk degeneration.
- Thickened ligaments.
- Paget's disease of the bone.
- Spinal tumors.
Consult your doctor is you have numbness, or weakness in your back, legs, neck or arms. If spinal stenosis is suspected, your doctor may refer you to a neurologist or spinal surgeon.
Although there are no cures for spinal stenosis, many therapies are available. Most doctors agree that mild disease should be treated conservatively with therapies such as:
- NSAIDs (non-steroidal anti-inflammatory drugs).
- Analgesics (Tylenol).
- Epidural steroid injections.
- Restricted activity.
- Physical therapy.
- Support devices such as a lumbar brace/corset.
Lifestyle and home remedies for spinal stenosis of the neck include application of heat or cold packs. If you have spinal stenosis of the lower back, losing excess weight can reduce stress on your joints and bones. For many patients, regular exercise focused on flexion-based exercises -- especially in combination with low-impact activities such as walking, swimming, and stretching exercises -- can decrease pain. But it's important to avoid any activities that can cause or worsen pain and disability.
If conservative approaches fail to relieve your symptoms, you may require surgery, which is only recommended if you have:
- Weakness or numbness in the legs.
- Difficulty walking or standing.
- Leg pain that limits normal activity.
- Reasonably good health.
In increasing order of complexity, surgical options include:
- Laminectomy (decompression).
- Laminotomy.
- Foraminotomy.
- Spinal fusion, which may involve a variety of implants.
If you're considering surgery, carefully consider the risks and benefits. According to a 2010 study published in the Journal of the American Medical Association, the use of complex surgical procedures to treat back pain has increased 15-fold in recent years, partly because surgeons have a financial incentive to perform them.
Compared to patients who undergo simpler surgery, the researchers found that those who undergo complex surgical procedures are about twice as likely to suffer complications (5.6 percent versus 2.3 percent) or return to the hospital within 30 days (13 percent versus 7.8 percent), and three times as likely to experience a life-threatening complication. They also found that average hospital costs were significantly higher ($80,888 versus $23,724).
The authors concluded that the extra hazards and expenses associated with complex surgical procedures are usually not justified. In general, they said that complex procedures don't have much advantage over simpler surgeries for relieving pain and improving functional recovery.
Copyright © 2010 HealthDay. All rights reserved.
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