A diagnosis we frequently see in our physical therapy clinics associated with back and neck pain is spinal stenosis. Spinal stenosis is a condition resulting in the narrowing or pinching of the spinal cord that causes pressure on the spinal cord and the nerves that flow through it. Spinal stenosis is most commonly found in individuals 45 years of age and older, however, can be found in the younger population as well. Some cases of spinal stenosis may also be congenital, which means it is present at birth. Spinal stenosis can occur throughout the spinal cord ranging from the cervical spine to the lumbar spine. However, thoracic stenosis is very uncommon because there is very little movement of these vertebrae, resulting in a lower chance of degeneration.
Overall, spinal stenosis symptoms are often characterized as:
- Developing slowly over time, or slow onset
- The pain you feel is not constant, or some describe it as coming and going.
- Occurring during certain activities (such as walking for lumbar stenosis) and/or positions (such as standing upright for lumbar stenosis)
- The pain is relieved by rest (sitting or lying down) and/or any flexed forward position.
There are many cases involving spinal stenosis where the person does not present with any symptoms at all. However, more times than not, a person will show signs and symptoms of spinal stenosis which differ from one region of the spine to the other. More specifically, signs and symptoms for the cervical spine can be weakness, and or numbness and tingling in the arms and hands, as well as local pain in the neck. In lumbar stenosis, the spinal nerves become compressed and can produce symptoms of sciatica, such as numbness and tingling, and or pain radiating into the buttock and legs.
Can Spinal Stenosis be treated?
The answer is, yes, spinal stenosis can be treated with several different methods, most of which do not require surgery. Courses of treatment include Physical Therapy, activity modification, epidural injections, and medication.
Physical Therapy – A physical therapy program consisting of strengthening, stretching, modalities, and manual work from a licensed therapist is a great course of treatment to decrease or eliminate pain.
Activity Modification – Patients are usually counseled to avoid activities that worsen their spinal stenosis symptoms. For lumbar stenosis patients, certain positions are more comfortable such as flexed positions. Example would be getting relief when leaning over onto a shopping cart at the grocery store.
Epidural Injections – An epidural injection is a shot of cortisone into epidural space which can temporarily relieve symptoms of spinal stenosis. This procedure would be performed by a licensed physician.
Medications – There are several medications that can help alleviate some of the pain that is caused by spinal stenosis, however it is always recommended that you consult with your physician prior to taking any medications.
Unfortunately not all cases of spinal stenosis are cured or managed with non-invasive treatments. In some cases an orthopedic surgeon will have to perform surgery to decrease the compression of the nerves that exit the vertebrae. This course of treatment is usually done as a last resort if the non-invasive courses of treatment have failed.
Spinal stenosis can be a very painful and debilitating condition, but it can be treated. If you suffer from neck or low back pain, you should talk to your physician or make an appointment with an orthopedist to be properly evaluated. You and your physician should come up with a treatment plan that is safe and suitable for you.
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