“Stenosis” is a Greek term that means abnormal narrowing of the blood vessels or other tubular organs or structures present inside the body. It can occur anywhere in your body, but here we are going to talk about spinal stenosis. So, what is spinal stenosis?
About 20% of adults over 60 have evidence of spinal stenosis on imaging scans, but more than 80% don't experience symptoms. Spinal stenosis, as the name suggests, happens in your backbone—or what we medically call your spine. It occurs when the space inside the backbone becomes too small or narrow, putting pressure on the spinal cord and the nerves traveling through your spine. It most commonly happens in your lower back or neck region.
Symptoms
Some people experience no symptoms, but when they do, the symptoms progress slowly and worsen over time. The symptoms depend on which part of the spine is affected:
In the Lower Back
Pain or cramping in one or both legs, especially when standing for a long time or walking.
Symptoms improve when bending forward or sitting.
Some people also experience back pain.
In the Neck
Numbness, tingling, or weakness in a hand, leg, foot, or arm.
Problems with walking and balance.
Neck pain.
Problems with bowel or bladder control.
Causes
Spinal bones are arranged in a column from the skull to the tailbone. They protect the spinal cord, which runs through an opening called the spinal canal. Spinal stenosis occurs when something reduces the amount of open space within the spine, including:
Bone Spurs: Wear-and-tear damage from arthritis can cause extra bone growth, creating bone spurs that push into the spinal canal.
Herniated Disks: Disks act as shock absorbers between spinal bones. If the disk's soft inner material leaks out, it can press on the spinal cord or nerves.
Thick Ligaments: Over time, the strong cords that hold the spine together can stiffen and thicken, pushing into the spinal canal.
Tumors: Rarely, tumors can form inside the spinal canal.
Spinal Injuries: Trauma, such as car accidents, can cause spinal bones to break or move out of place. Swelling after back surgery can also put pressure on the spinal cord or nerves.
Diagnosis & Tests
A healthcare professional will review your medical history, ask about your symptoms, and perform a physical examination. They may feel your spine and press on different areas to see if it causes pain. They may also ask you to bend in different directions to see if certain spine positions bring on symptoms.
Imaging tests can provide a better diagnosis and pinpoint the exact location of the affected area. Common tests include:
X-rays: Reveal changes in bone structure, such as loss of disk height or bone spurs.
MRI: Provides detailed images of nerves, disks, and the spinal cord, and can reveal tumors.
CT scan or CT Myelogram: Uses contrast dye to offer a clearer view of the spinal cord and nerves.
Management & Treatment
Treatment for spinal stenosis primarily focuses on managing symptoms. Options include:
Oral Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve inflammation and pain.
Steroid Injections: Corticosteroids injected into the space around pinched spinal nerves reduce inflammation and pain.
Surgery: In severe cases, surgical intervention may be required.
How Can a Physical Therapist Help?
A physical therapist aims to help you maintain your daily activities and life roles. They will design a treatment program based on your specific needs, which may include:
Gentle Movement: Specific movements to relieve nerve pressure and alleviate pain.
Stretching and Range-of-Motion Exercises: Improves joint and muscle mobility, reducing pain.
Strengthening Exercises: Strong trunk (abdomen and back) muscles support the spine, while strong arm and leg muscles reduce the workload on spinal joints.
Aerobic Exercise: Improves tolerance for activities affected by spinal stenosis, such as walking.
Physical therapists may also use:
Manual Therapy: Hands-on therapy, like massage, to improve stiff joint mobility.
Rehabilitation Equipment: Tools like a treadmill harness device to reduce spinal nerve pressure during walking.
Postural Education: Guidance on standing, walking, and sitting to reduce stress on nerves.
Spinal stenosis can be managed effectively with proper diagnosis, timely treatment, and a combination of medical and physiotherapeutic interventions. If you suspect spinal stenosis, consult a healthcare provider for personalized advice and care.
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