Imagine the nerves in your back run through a tunnel. Now, imagine that tunnel starting to get smaller, putting the squeeze on those important nerves. That’s a simple way to understand spinal stenosis.
In more medical terms, spinal stenosis is the narrowing of the spaces within your spine. This narrowing can put pressure on the nerves that travel through the spine, including the spinal cord itself. Think of it like a ring that’s become too tight on a finger. Over time, this pressure can lead to pain, tingling, numbness, and muscle weakness.
Spinal stenosis can happen in any part of your spine, but it’s most common in two areas:
- Lumbar Stenosis: This is the most common form of spinal stenosis and occurs in the lower back.
- Cervical Stenosis: This type occurs in the neck area.
While the idea of a narrowing spinal canal might sound alarming, it’s a relatively common condition, especially as we get older. The good news is that there are many effective treatments available to manage the symptoms and improve your quality of life. At California Pacific Orthopaedics, our team of spine specialists in San Francisco is dedicated to helping you find the right solution for your back and neck pain.
Common Symptoms and Causes
The symptoms of spinal stenosis often start slowly and get worse over time. They can also vary depending on where the narrowing is and which nerves are being affected.
Symptoms of Lumbar (Lower Back) Spinal Stenosis
- Pain or cramping in one or both legs when you stand for long periods of time or when you walk. This pain usually eases when you bend forward or sit down. This is sometimes called “neurogenic claudication” or “pseudoclaudication.”
- Back pain
- Numbness, tingling, or weakness in a leg or foot
Symptoms of Cervical (Neck) Spinal Stenosis
- Neck pain
- Numbness or tingling in a hand, arm, foot, or leg
- Weakness in a hand, arm, foot, or leg
- Problems with walking and balance
- In severe cases, bowel or bladder dysfunction (urinary urgency and incontinence)
What Causes the Spine to Narrow?
The most common cause of spinal stenosis is osteoarthritis, the “wear and tear” arthritis that can cause the cartilage in your joints to break down. In the spine, osteoarthritis can lead to:
- Bone spurs: The body may grow extra bone, called bone spurs or osteophytes, to try to support the spine. These can grow into the spinal canal.
- Thickened ligaments: The tough cords that help hold the bones of your spine together can become stiff and thick over time, bulging into the spinal canal.
- Herniated discs: The soft cushions that act as shock absorbers between your vertebrae can dry out with age. Cracks in a disc’s exterior may allow some of the soft inner material to escape and press on the spinal cord or nerves.
- Tumors: Abnormal growths can form inside the spinal cord, within the membranes that cover the spinal cord, or in the space between the spinal cord and vertebrae.
- Spinal injuries: Car accidents and other trauma can cause dislocations or fractures of one or more vertebrae. Displaced bone from a spinal fracture may damage the contents of the spinal canal.
Common Risk Factors
While anyone can develop spinal stenosis, certain factors can increase your risk.
- Age: Spinal stenosis is most common in people over the age of 50.
- Genetics: Some people are born with a small spinal canal.
- Spinal deformity: Conditions like scoliosis (a curvature of the spine) can increase your risk.
- Previous injury: A prior injury to the spine can contribute to the development of spinal stenosis.
When to See a Spine Specialist in San Francisco
If you’re experiencing persistent pain, numbness, or weakness in your back, neck, legs, or arms, it’s time to see a doctor. While these symptoms can have many causes, a proper diagnosis is the first step toward getting the right treatment.
The spine specialists at California Pacific Orthopaedics have the expertise to determine if your symptoms are caused by spinal stenosis or another condition. We’ll work with you to create a personalized treatment plan to help you get back to the activities you love.
Diagnosing Spinal Stenosis
To diagnose spinal stenosis, your doctor will start by asking about your symptoms and medical history. They will also perform a physical exam. To get a closer look at your spine, your doctor may order imaging tests, such as:
- X-rays: These can show changes in the bones of your spine, such as bone spurs.
- Magnetic resonance imaging (MRI): This test uses a powerful magnet and radio waves to create detailed images of your spine, including the nerves and discs.
- CT scan: A CT scan combines X-rays taken from many different angles to create cross-sectional images of your spine.
Treatment Options for Spinal Stenosis
There are a variety of treatment options for spinal stenosis, ranging from conservative therapies to surgery. The right treatment for you will depend on the severity of your symptoms and how much they are affecting your daily life.
Nonsurgical Treatments
For many people, a combination of these treatments is enough to provide relief:
- Physical therapy: A physical therapist can teach you exercises to help strengthen your back and leg muscles, improve your flexibility and balance, and reduce your pain.
- Medications: Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), can help relieve pain and inflammation. In some cases, your doctor may prescribe stronger medications.
- Steroid injections: Injections of corticosteroid medication into the space around the pinched nerve can help reduce inflammation and relieve pain.
- Assistive devices: Using a cane or walker can help you maintain your independence and mobility.
Surgical Treatments
If nonsurgical treatments don’t provide enough relief, your doctor may recommend surgery. The goal of surgery for spinal stenosis is to relieve the pressure on your spinal cord or nerves. Common surgical procedures include:
- Laminectomy: This procedure involves removing the lamina, the back part of the vertebra that covers your spinal canal. This enlarges your spinal canal to relieve pressure on the nerves.
- Laminotomy: In this procedure, only a small part of the lamina is removed to relieve pressure in a specific spot.
- Spinal fusion: In some cases, it may be necessary to fuse two or more vertebrae together to stabilize the spine.
The surgeons at California Pacific Orthopaedics are highly experienced in performing these procedures and will work with you to determine if surgery is the right option for you.
Your Next Steps
Living with the pain and limitations of spinal stenosis can be challenging, but you don’t have to go through it alone. The team at California Pacific Orthopaedics is here to help. We are committed to providing our patients in the San Francisco Bay Area with the most advanced and compassionate care for spinal stenosis and other orthopedic conditions.
To learn more about your treatment options or to schedule an appointment with one of our spine specialists, please contact us today.
