Could Spinal Stenosis Be Causing Your Chronic Back Pain?

Spinal stenosis can affect people of any age, but it’s most common in adults over 50. If you’re an older adult and have back pain that’s getting worse, you may have spinal stenosis. Read on to learn about symptoms and treatments as well as tips for living with this condition.

What Is Spinal Stenosis?

Spinal stenosis occurs when the spaces in the spinal cord narrow. It’s most likely to happen in the neck (cervical spine) or lower back (lumbar spine). As a space narrows, it puts pressure on the nerves to the arms or legs, depending on the location of the stenosis.

What Symptoms Will I Notice?

If the pinched nerve is in your neck, you may feel pain, numbness, and weakness in your arms and down into your hands. You may also feel a burning sensation.

If the stenosis is in your lower back, you may feel numbness and weakness in your legs. You might have sciatica, which is a burning pain in a buttock that goes down your leg. You may also notice foot drop or loss of sensation in your feet. In some cases, you could also have trouble walking.

No matter where your pinched nerve is located, these symptoms can gradually get worse. Some people with spinal stenosis can have problems controlling their bowel or bladder. It can also make sex difficult.

What Causes Spinal Stenosis?

If you’re having spinal stenosis symptoms like these, they’re probably due to normal wear and tear in the spine (osteoarthritis) that can be a natural part of aging. Arthritis causes the cartilage to wear away, which can cause bones to rub together and spaces between the bones to narrow. When this happens, nerves to the arms and legs can get pinched.

There are also uncommon causes of spinal stenosis that can happen at any age. They include a herniated disc (also called a ruptured disk), bone spurs that can grow into the spinal canal, fracture from an injury, a tumor, or certain other medical conditions.

How Is this Condition Diagnosed?

To find out for sure if your symptoms are from spinal stenosis, your provider will do a physical exam. They will take a medical history to learn if an injury could be causing your pain. They will probably order imaging tests. This could mean x-rays, a computed tomography CT (CT scan), magnetic resonance imaging (MRI), or bone scans. They may also order an electromyogram (EMG).

What Treatment Options Are Available?

If the diagnosis is spinal stenosis, you will have some decisions to make. There is no cure for spinal stenosis, but there are treatments for it. Your options will depend on how severe your symptoms are. Your provider may offer nonsurgical therapies, medication, or surgery to relieve pain.

Nonsurgical Treatment for Spinal Stenosis

Nonsurgical treatment usually includes things like back braces and chiropractor visits. This type of therapy is not typically helpful in the long term for pinched nerves. However, physical therapy and acupuncture are two nonsurgical treatments that some people find helpful.

Physical Therapy (PT)

PT can be your best choice if you want to put off getting surgery. You would see a therapist to learn exercises to help with your pain. Sometimes people can stop going to therapy after a while and continue their exercises on their own at home. PT can help you feel better for a while, but you may still need surgery eventually.

Acupuncture

Acupuncture can sometimes help, but the results are only temporary. You would need to have it done regularly.

Medication

If you choose to try medication, you should seek medical advice first. Your provider may recommend aspirin, acetaminophen (Tylenol), ibuprofen (Motrin or Advil), or naproxen (Aleve). These meds can help with early symptoms of pain and inflammation.

For more severe pain, your provider may recommend prescription pain medications, steroid injections, or nerve blocks.

Surgery

If the pain gets to the point that you don’t want to deal with it anymore, it may be time to talk to your doctor about surgery. They may recommend a laminectomy, an operation that can take the pressure off pinched nerves. A laminectomy can be done as an open or minimally invasive procedure. If you start having significant leg weakness or loss of bowel or bladder control, the sooner you schedule surgery, the better.

Risks of Surgery for Spinal Stenosis

Complications are rare with a laminectomy, but like all surgeries, there are risks involved. Possible complications include:

• There is a less-than-three percent chance that your incision could become infected. If that happens, you may need another procedure to treat the infection. You may also need IV antibiotics.
• Incomplete relief. If you have had a pinched nerve for a long time, you might still have some symptoms after surgery.
• A small number patients may experience new numbness or weakness (post-laminectomy syndrome, also called failed-back syndrome) following laminectomy.
• Dural tear. The dura is a sac that surrounds the nerve roots in your spinal cord. There is a risk that the dural sac can tear during surgery. If that happened, you would need another operation to repair it.
• Need for fusion. Sometimes the only way to relieve the pain is to trim or remove bone that pinches the nerve. The process can weaken your spine, so you might need spinal fusion surgery with bone graft to strengthen it.

All of these complications can be treated, but they can make recovery take longer.

Living with Spinal Stenosis

If you would prefer to avoid surgery, here are some things that can help you deal with your pain:

• Pace yourself. You may need to make changes in activities that cause you pain.
• Keep moving. Exercise three times a week for 30 minutes if you can. If you aren’t seeing a physical therapist, ask your provider to show you safe exercises you can do at home. You can also find back exercises
• Pay attention to your posture. Leaning forward stretches the spine, and some people find it helps with pain.
• Use a wheeled walker. A walker with a seat can help you exercise. Push it when you walk, then rest on the seat when you need to. Even pushing a shopping cart could make your pain feel better.
• Watch your weight and diet. Obesity can make back pain worse.
• If you smoke, quit. Smoking can worsen pain and make recovery from surgery more difficult.

To learn more about spinal stenosis and how to cope with it, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

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