Spinal stenosis is a condition of the spine that is caused by narrowing of the space of the spinal canal. Narrowing of the space of the spinal canal can be caused by many abnormal conditions. Infection and tumors are two serious causes of stenosis but more commonly stenosis is caused by degenerative changes in the spine that occur over time. Other causes of spinal stenosis may include congenital or developmental abnormalities in the spine such as shortened pedicles.
The degenerative changes in the spine leading to spinal stenosis often occur slowly over time. Examples of these changes include bony hypertrophy or what is commonly called bone spurring, thickening of ligaments in the spine and central disc herniations. It is often an injury which brings out the symptoms of stenosis.
Symptoms of stenosis of the spine may include pain in the legs which is triggered by prolonged standing or walking and often relieved by walking or sitting in a forward bent posture. Patients may also experience numbness, tingling, and hot or cold sensations in the legs. Muscle weakness and spasms are a common symptom as well.
Spinal stenosis is diagnosed based upon the patient’s history of symptoms, the physical examination and imaging studies that are done. MRI of the spine is especially useful for visualizing stenosis and confirming the diagnosis. Electrodiagnostics which include electromyograms and nerve conduction velocity studies are a better predictor of disability related to spinal stenosis and can better evaluate how the nerves in the lower extremities are functioning.
Treatment of spinal stenosis is based upon the cause. Tumors, fractures, infections are best treated medically. Degenerative or biomechanical causes are best treated conservatively and often respond very well to chiropractic treatment. In severe cases, where other approaches have failed to manage the symptoms, surgery may be required.
Chiropractic management of spinal stenosis may include physiotherapy modalities to help control pain, spasm and inflammation. Gentle adjustments to the spinal joints can help reduce biomechanical stress on the joints alleviating pressure on the exiting nerve roots.
Rehabilitative exercises to strengthen and stretch muscles critical to keeping the spine in good alignment and to keep the patient moving and functioning are taught to the patient. Weight control and good nutrition to help the body repair and lower pain and inflammatory responses in the body is another important focus of chiropractic management for spinal stenosis.
Spinal stenosis is a chronic condition that most often is not cured but managed over time. Your Doctor of Chiropractic is well trained to diagnose the condition as well the underlying cause of the spinal stenosis.