Back pain can be spinal stenosis related. Spinal stenosis pain occurs when the spaces within your spine (foramina) begin narrowing and reduce space for nerves. This may put pressure on the nerves that travel through the spine.
Said condition occurs most often in the lower back (lumbar stenosis) and neck (cervical stenosis), but it might also appear in the thoracic spine (middle of your back). You can have one or more types of spinal stenosis. Lumbar stenosis is the most common.
There is no cure, but, there’s a wide variety of treatments. Most people with spinal stenosis live normal lives.
Symptoms of Spinal Stenosis
Some people with spinal stenosis do not have symptoms. The spinal canal narrowing is usually a slow process that worsens over time.
Furthermore, people with symptoms tend to experience pain, tingling, numbness, and muscle weakness. Spinal stenosis symptoms, if left untreated, tend to worsen over time.
Symptoms of cervical (neck) stenosis
Numbness or tingling in a hand, arm, foot, or leg
Weakness in a hand, arm, foot, or leg
Problems with walking and balance
Loss of bladder or bowel control (in severe cases only)
Symptoms of lumbar stenosis (lower back)
Tingling (“pins and needles”) in a foot or leg;
Weakness in a foot or leg
Lower back pain that is often described as a dull ache, tenderness, or burning sensation
Sciatica. Pain that begins in the buttocks and extends down to the leg (possibly continuing down to your foot)
Pain that worsens when standing for long periods of time or walking
Pain that lessens when learning, bending slightly forward, or sitting
Loss of bladder or bowel control (in severe cases)
Symptoms of thoracic spinal stenosis (abdomen area):
Weakness, pain, numbness or tingling at or below the level of the abdomen
Problems with balance
While spinal stenosis is commonly associated with pain that radiates into the leg or arm, sometimes the pain is felt more locally within the spine.
Usually, spinal stenosis and back pain symptoms …
Develop slowly over time
Come and go, meaning they are not continuous pain
Occur mostly when practicing certain activities (walking, for example) or in certain positions (standing upright, in the case of lumbar stenosis)
Relieve with rest or any flexed position, such as forward bending
Spinal Stenosis Complications
Rarely, untreated severe spinal stenosis may bring some severe complications, such as permanent:
Note:that it’s very rare for spinal stenosis to cause paralysis. Usually, the narrowing of the spine only causes the symptoms described before.
However, if the spinal nerve or spinal cord is compressed for an extended period, permanent numbness and or paralysis are possible.
Diagnosis of Spinal Stenosis related back pain
Your healthcare provider may ask you about your symptoms, discuss your medical history and risk factors, conduct a physical examination, and order imaging tests to diagnose spinal stenosis.
He, she or they may feel your spine during the physical exam, pressing on different areas to see if it causes pain. You’ll probably be asked to bend in different directions to see if different spine positions bring on pain and other symptoms.
Imaging and Tests
Magnetic Resonance Imaging (MRI). An MRI can detect damage to your disks and ligaments. Most importantly, for the diagnosis of spinal stenosis, the MRI can show where the nerves in the spinal cord are being pressured.
CT. If you can’t have an MRI, your doctor may suggest a computerized tomography (CT) to diagnose spinal stenosis.
X-rays. X-rays use a small amount of radiation that can detect loss of disk height and the development of bone spurs narrowing the space in your spine.
Treatment for Spinal Stenosis and related back pain
Surgery may not be needed for your situation. Usually, if the pain is very mild, you can get better with some self-care tips from your doctor. If that doesn’t work, it’s common to move to medication and physical therapy.
If the treatments mentioned above don’t work, then your healthcare provider might consider surgery.
Self-help remedies for Spinal Stenosis Related Back Pain
Heating Pads. Heat increases blood flow, which relaxes muscles and relieves aching joints. Be careful when you use heat, don’t use too much heat to avoid burns.
Apply cold. If the heat isn’t easing your symptoms, try using ice. Ice helps reduce swelling, tenderness, and inflammation. Try to limit the use of ice to 20 minutes. Typically ice is applied 20 minutes on and 20 minutes off.
Exercise. DO NOT try this without talking to your healthcare provider first. Exercise will help you relieve pain and strengthen your muscles to support your spine, but it should be done within the limitations of your condition.
Medications your doctor may prescribe
Pain relievers. Pain medications such as ibuprofen (Advil), naproxen (Aleve), and acetaminophen (Tylenol) may be temporarily used to ease the discomfort caused by spinal stenosis. These treatments are usually prescribed short-term, as there’s little evidence of them benefiting patients after long-term use.
Opioids. Drugs such as Oxycontin and Vicodin may also be used for short-term pain relief. Opioids should be very carefully considered for long-term treatment because they carry the risk of severe side effects, such as them becoming habit-forming.
Antidepressants. Tricyclic antidepressants can help ease chronic pain.
Muscle relaxants. These can help control muscle spams, one of the most common culprits of your back pain.
Anti-seizure medication. This type of medication can ease pain from damaged nerves.
Anesthetics, known as “nerve blocks.” The injection of a “nerve block” can stop pain for a time.
Physical therapy for Spinal Stenosis related back pain
It’s common for people with spinal stenosis to become less active to reduce the pain. However, that’s a double-edged sword, as lack of activity can lead to muscle weakness, leading to more pain.
Physical therapists can teach you exercises to build up your strength and endurance, maintain the flexibility of your spine, and improve your balance.
Your nerve roots may become irritated and swollen where they are being pinched. Steroid injections do not cure spinal stenosis, but they can help reduce inflammation and relieve pain.
You should talk to a health provider specialized in pain management if you’re considering steroid injections. There are some cons associated with frequent use, so they should be used responsibly.
If the treatments mentioned above have not helped and your symptoms have a high impact on your quality of life, your doctor may recommend surgery.
The goal of surgery is to relieve the pressure on your spinal cord or nerve roots by creating more space within the spinal canal.
There is more than one surgery available for the treatment of stenosis. You should discuss your symptoms and treatment history with your surgeon so they can choose the best course of action.
Alternative medicine for Spinal Stenosis Related Back Pain
Alternative medicine therapies may be used with other conventional treatments to help you cope with Spinal Stenosis related back pain. Examples of alternative therapies that can help you with spinal stenosis pain include:
Spinal stenosis is most commonly caused by wear-and-tear changes in the spine related to osteoarthritis.
Some people are born with a small spinal canal, but most spinal stenosis happens when something causes the narrowing of the open space within the spine.
Some causes of spinal stenosis include:
Bone overgrowth. As the cartilage wears away in osteoarthritis, the bones begin to rub against each other. Your body responds by growing new bone; that’s when an overgrowth of bone (bone spurs) occurs. This overgrowth compresses the nerves.
Bulging disks or herniated disk. Bulging discs press on the nerves near them.
Thickened ligaments. Arthritis can cause ligaments to thicken over time and bulge into the spinal canal space, causing spinal stenosis.
Spinal fractures and other injuries. Broken or dislocated bones can narrow the canal space and/or put pressure on spinal nerves.
Spinal cord cysts or tumors. Growths within the spinal cord or between the spinal cord and vertebrae can narrow the space and put pressure on the spinal cord and its nerves.
Congenital spinal stenosis. This means a person is already born with a small spinal canal. Scoliosis, another congenital spinal deformity, may also put a person at risk for spinal stenosis.
Common Risk Factors
Most people with spinal stenosis are over the age of 50, and it’s common in both women and men. Younger people who suffer from conditions that affect the spine, such as scoliosis, and those born with a narrow spinal canal are also at risk.
When to see a Doctor (MD)
You should see a doctor if you feel any of the symptoms mentioned in this post’s “Symptoms” section.
You experience numbness and weakness in your legs.
You lose control of your bladder and /or bowels. This may mean you’re suffering from a rare disorder called Cauda Equina Syndrome. If that’s the case, you need immediate medical help to prevent permanent incontinence or paralysis.
Preparing for your appointment
If your primary care doctor thinks you have spinal stenosis, they may refer you to a neurologist or neurosurgeon.
Before the appointment, you might want to prepare a list of answers to the following questions:
When did you first notice this problem?
Has it worsened with time?
Have your parents or siblings ever had similar symptoms?
Do you have other medical issues?
What medications or supplements do you take regularly?
What spine surgeries or injections have you had done?
Do you have pain? Where is it?
Does any position ease the pain or worsen it?
Do you have any weakness, numbness, or tingling?
Do you feel more clumsy lately?
Have you had any difficulty controlling your bowel or bladder?
What treatments have you tried already for these problems?
Spinal stenosis and back pain is treatable. In addition, it doesn’t require surgery often.
A combination of medication and self-care should help you if you suffer from mild to moderate pain.
If you need help with pain management for spinal stenosis, schedule a consultation today at our Nona Medical Arts Orlando office, or Merritt Island office by calling (407) 318-7873.