Spinal stenosis is a common condition where the small spinal canal, which contains the nerve roots and spinal cord, becomes compressed. This pinches the nerves and spinal cord, causing pain, cramping, weakness, or numbness affecting the lower back and legs, neck, shoulders, or arms.
Exercises which flex, stretch or strengthen the back and neck can help to open up the spine, alleviating compression symptoms. Canes and walkers can also be used to walk in a forward flexed manner and provide some stability.
Spinal stenosis is a narrowing of the lumbar or cervical spinal canal. The narrowing can cause compression on nerve roots resulting in pain or weakness of the legs. Medications or steroid injections are often administered to reduce inflammation.
Symptoms of lumbar stenosis
Symptoms like aching, cramping, tingling, heaviness and occasional weakness in the legs are usually brought on by walking or standing. They can be eased by sitting or leaning forward. Patients with lumbar stenosis can also have back pain.
Medicines may include nonsteroidal, anti-inflammatory medicines that relieve pain and swelling, and steroid injections that reduce swelling. Surgical treatments include removing bone spurs and widening the space between vertebrae. The lower back may also be stabilized by fusing together some of the vertebrae.
Acetaminophen (eg, Tylenol), aspirin, ibuprofen (eg, Motrin, Advil), and naproxen (eg, Aleve) are examples of OTC analgesics that your doctor may recommend for spinal stenosis.
The latest lumbar spinal stenosis treatment has been referred to with many different names, including non-fusion implant and dynamic stabilization system, among others. These names all refer to devices that are used in place of spinal fusion to provide stability and symptom relief.
Spinal stenosis symptoms may start slowly and worsen over time. Leg pain may become so severe that walking short distances is unbearable. People with spinal stenosis may experience numbness, weakness or cramping in legs, pain going down the leg, abnormal bowel or bladder function, and loss of sexual function.
If your stenosis symptoms don't respond to home remedies or conservative treatment, or if the condition is so painful or debilitating that it affects your daily life, then you likely have severe spinal stenosis.
Depending on where and how severe your spinal stenosis is, you might feel pain, numbing, tingling and/or weakness in your neck, back, arms, legs, hands or feet. Normal spine with no narrowing of the space around the spinal cord or nerve roots exiting the spinal column.
In spinal stenosis, people typically experience less pain with leaning forward, and especially with sitting. Studies of the lumbar spine show that leaning forward can increase the space available for the nerves. Pain is usually made worse by standing up straight and walking.
Walking, standing, or extending the lumbar area of the spine can cause symptoms to worsen. Sitting or flexing the lower back or neck may relieve symptoms. The flexed position “opens up” the spinal column, enlarging the spaces between vertebrae at the back of the spine.
Therapies and Lifestyle Changes
Heat can reduce muscle tension and tightness. Exercise: Whether under the direction of a physical therapist or simply trying to increase the number of steps you take each day, exercise can strengthen the muscles around your spine and improve your flexibility.
A neurosurgeon may perform a laminectomy with or without fusing vertebrae or removing part of a disk. A spinal fusion with or without spinal instrumentation may be used to enhance fusion and support unstable areas of the spine.
Stenosis is considered severe when it causes loss of certain functions or disabilities, or when other treatment options have failed to relieve symptoms. You should consult an expert neurosurgeon to assess your symptoms.
Many people with mild spinal stenosis find that nonsurgical treatments such as pain medication and physical therapy relieve symptoms and help them remain active. NYU Langone spine specialists work with experts in pain management, rehabilitation, and orthotics to create a treatment plan.
Pain medications may be helpful with relieving spinal stenosis-related back pain, depending on what type of medication it is. Many over-the-counter drugs like ibuprofen work well, but there are prescription medications as well, such as Voltaren (diclofenac) and Naproxin (naproxen).
Most people have good results from surgery and are able to return to a normal lifestyle after they heal. People tend to have less leg pain and can walk better afterward. However, surgery doesn't cure arthritis or other conditions that might have caused the spinal canal to narrow in the first place.
The best muscle relaxer for spinal stenosis can vary from patient to patient. However, the best options include baclofen, cyclobenzaprine, and methocarbamol. Baclofen is an antispastic drug that's widely used to treat muscle spasms in spinal cord conditions, including lumbar spinal stenosis.
Common muscle relaxants include Flexeril, Soma, Baclofen, Robaxin, and Tizanidine. Nerve membrane stabilizers are another class of medications often used to treat the numbness, tingling, shooting, stabbing, or radiating pain associated with spinal stenosis.
Weight loss and physical therapy are common first line treatments recommended for reducing lumbar lordosis.
As a result, climbing stairs reduces the amount of space in the spinal canal. This temporarily exacerbates the effects of spinal stenosis, potentially leading to worsened pain and other symptoms. If you've been diagnosed with spinal stenosis, it's wise to keep climbing stairs to a minimum.
Many people with spinal stenosis find the most comfort sleeping on their side in “fetal position” — that is, with knees curled up toward the abdomen. Another alternative is to sleep in an adjustable bed or recliner that allows the head and knees to remain elevated.
While anti-inflammatory medications may ease symptoms, in the long run you may be better off changing your posture and the way you move. Surgery is a good option for some people with lumbar spinal stenosis. But, for some people, physical therapy can often achieve good results with fewer risks.