WHAT IS STENOSIS?
Spinal stenosis is created by the narrowing of the spinal canal. This narrowing may be caused by mechanical problems or by abnormalities in the aging spine. It may or may not result in low-back pain, limping, and a lack of feeling in the legs. Stenosis is often a degenerative condition. It may exist for years without causing pain or discomfort, but a fall or an accident can trigger characteristic stenotic pain. Numerous factors can cause stenosis, such as thickened ligaments, expanding infection, abscess, a congenital or developmental anomaly, degenerative changes, vertebral fractures or dislocations, or a spinal cord tumor.
Other conditions, such as a herniated disc, can mimic stenosis. While herniated discs usually cause rapid and acute muscle spasm, discomfort caused by stenosis builds gradually. Other conditions that can be confused with stenosis include vascular claudication, peripheral vascular disease, and abdominal aortic aneurysms. Claudication—pain triggered by walking—caused by vascular disease most often occurs after walking a fixed distance. Patients with spinal stenosis, however, walk variable distances before symptoms set in. Activities like riding a bicycle and walking up a hill can cause pain in patients with vascular claudication, but not in those with stenosis. On the other hand, standing makes pain worse for stenotic patients, while it relieves vascular claudication.
How is stenosis treated?
There are three basic treatment approaches to spinal stenosis:
- The conservative medical approach, which frequently involves bed rest, analgesics, local heat, and muscle relaxants
- The conservative chiropractic approach, which includes manipulation, exercise and self-care techniques
In many mild and moderate cases of stenosis, however, non-invasive conservative care, such as chiropractic, can help lessen pain and discomfort, maintain joint mobility, and allow the patient to keep a reasonable lifestyle, at least for some time. A technique called distraction manipulation may be helpful in reducing leg discomfort. Home exercises are a major part of the conservative treatment program. It is recommended to exercise four or five times a week with physical activities such as riding on the bicycle or lying on the side and grasping the knees with the arms, focus on flexing the spine in a forward position—stretching and strengthening the lower back and stomach muscles and improving muscle strength. Exercises designed to mobilize the involved nerves have been found to be particularly helpful.
Ultimately, stenosis is a chronic condition that cannot be “cured,” but it often can be improved, and improvement can be maintained over the long term. Patients can work with a health care provider, such as a doctor of chiropractic, to reduce symptoms and improve their quality of life.