Spinal Stenosis

What you should know about Spinal Stenosis

Spinal Stenosis

Spinal Stenosis is a debilitating  disease affecting many  elderly Americans. The  primary  cause is osteoarthritis  of  the  spine,  which  is  common with aging. Spinal stenosis may also be seen in patients  having had prior spinal surgery. Spinal stenosis may occur in the cervical, thoracic, or lumbar spine.

The vertebra of the spine interact in the so called "triple joint complex" which consists of the disc and  two facet  joints.  Osteoarthritis   causes the facet joints to degenerate and the surface lining these  joints  to   enlarge  and  become  inflamed. This   is  a  reaction   to   constant   friction   and destructive wear and tear. These joints eventually become eroded and cause back or neck pain. At  the  same  time,  the  disc  may  herniate  or degenerate. All this leads to  a narrowing of the canal in which  the spinal cord and  nerve roots lie. As the  canal narrows,  there  is  pressure on these nerves and this leads to  back and leg pain.

Spinal Stenosis causes pain on walking or prolonged  standing.  There   is  significant  back and leg pain. The  leg pain is often described as burning, shooting, stabbing and is relieved with rest.  Patients  often  find  leaning  forward  on  a shopping  cart  or  walking  uphill  alleviates the pain. Spinal stenosis can be so severe as to cause profound weakness and inability to walk, thus requiring back surgery.

Treatment  usually consists of physical therapy, medical  therapy  and  spinal  nerve  blocks. Epidural in jections are an effective treatment  for spinal stenosis.   This involves placing a small amount  of steroid into the epidural space which bathes the nerves and disc. Steroids are the most potent   anti-inflammatory  agents  known   and they  act  by  reducing   the   pressure  on   these nerves, thus relieving pain. The facet joints may also be injected with steroids for the same purpose