What is spinal stenosis and how is it treated?
Chronic back pain can feel like an unwelcome companion, affecting everything from your morning routine to your ability to enjoy your favorite activities. If you're experiencing persistent pain, numbness or weakness in your back, legs or neck, you might be dealing with spinal stenosis. While the diagnosis can sound intimidating, understanding what it is and the available treatments is the first step toward finding relief.
At DFW Interventional Pain Institute, our patient philosophy is that living with pain is not your only option. Advances in medication and therapeutic practices have opened up new possibilities for managing conditions like spinal stenosis. This guide will provide a comprehensive overview of spinal stenosis, including its causes, symptoms, and the various treatment options available to help you get back to living your best life.
What is spinal stenosis?
Spinal stenosis is a medical condition characterized by the narrowing of the spinal canal. Your spinal canal is the open space within your spine that houses the spinal cord and the nerves that branch out from it. When this canal narrows, it can put pressure on these nerves, leading to pain, numbness, cramping or weakness.
This narrowing most often occurs in two areas:
Lumbar stenosis: This is the most common form, affecting the lower back. The pressure on the nerves can cause pain or cramping in one or both legs, especially when you stand for long periods or walk.
Cervical stenosis: This type affects the neck. The narrowing can lead to neck pain, numbness, tingling or weakness in the arms and hands. In more severe cases, it can impact balance and coordination.
Causes and risk factors
Spinal stenosis is primarily caused by wear-and-tear changes in the spine related to aging. As we get older, the ligaments of the spine can thicken, and bone spurs (overgrowths of bone) may develop. Herniated discs and swollen joints can also contribute to the narrowing of the spinal canal.
While age is the most significant risk factor—most people diagnosed are over 50—other factors can contribute to its development, including:
Osteoarthritis: The gradual breakdown of cartilage in the joints can lead to the formation of bone spurs that encroach on the spinal canal.
Degenerative disc disease: As spinal discs lose water content with age, they can flatten and bulge into the spinal canal.
Past injuries: Trauma to the spine can cause dislocations or fractures that narrow the spinal canal.
Congenital factors: Some people are born with a smaller spinal canal, which can predispose them to stenosis.
Symptoms of spinal stenosis
The symptoms of spinal stenosis often develop gradually and can vary in intensity. Many people live with the condition for years without realizing it, only seeking help when the pain starts to significantly impact their daily life.
Common symptoms include:
Pain: A dull ache or sharp pain in the lower back or neck.
Numbness or tingling: Often felt in the legs, feet, arms, or hands.
Weakness: Difficulty with fine motor skills or a feeling of heaviness in the limbs.
Sciatica: Sharp, shooting pain that radiates from the lower back down the leg.
Balance problems: Feeling unsteady on your feet.
For those with lumbar stenosis, symptoms often worsen with walking or standing and may improve when sitting or leaning forward. This is because leaning forward can temporarily increase the space in the spinal canal, relieving pressure on the nerves.
Diagnosis and evaluation
Getting an accurate diagnosis is the cornerstone of effective treatment. At DFW Interventional Pain Institute, Dr. Lopez and our staff will take the time to listen to you, review your medical history and imaging and perform a thorough physical exam. We may ask you to perform certain movements to assess your range of motion and identify what triggers your pain.
To confirm a diagnosis of spinal stenosis, imaging tests are often required:
X-rays: Can show degenerative changes like bone spurs.
Magnetic Resonance Imaging (MRI): Provides detailed images of the spinal cord, nerves, and surrounding tissues, revealing any compression.
CT scan: Creates cross-sectional images of the spine and can be combined with a myelogram (a dye injected into the spinal fluid) for a clearer view of nerve pressure.
What are my treatment options?
After a thorough evaluation, Dr. Lopez and our team will develop a comprehensive treatment plan tailored to your specific needs, lifestyle and desired outcomes. The goal is to reduce pain and improve your ability to function in daily life.
Non-surgical treatments
For many patients, a combination of non-surgical treatments provides significant relief:
Medications: Over-the-counter pain relievers, anti-inflammatory drugs or muscle relaxants can help manage pain.
Physical therapy: A structured exercise program can help strengthen your back and abdominal muscles, improve flexibility, and enhance balance.
Epidural steroid injections: These injections deliver a powerful anti-inflammatory medication directly to the area around the irritated nerves, providing temporary but effective pain relief.
Surgical treatments
If conservative treatments don't provide adequate relief and your quality of life is severely impacted, surgery may be an option. The primary goal of surgery is to decompress the spinal canal and relieve pressure on the nerves. Dr. Lopez can provide a surgical referral when appropriate.
Find relief from spinal stenosis pain at DFW Interventional Pain Institute
Living with spinal stenosis can be challenging, but you don't have to face it alone. With a proper diagnosis and a tailored treatment plan, it is possible to manage your symptoms and maintain an active, fulfilling lifestyle. Whether through physical therapy, innovative injections, or other therapies, our team at DFW Interventional Pain Institute is here to help.
Dr. Edrick Lopez, a double board-certified, Harvard-trained interventional pain management physician, has helped thousands of patients find relief from chronic pain. His comprehensive and patient-centered approach ensures that you receive the highest level of care. If you're experiencing symptoms of spinal stenosis, we encourage you to book an appointment with us and explore the treatment options that can help you live your best life.
