In years past, I only discussed the topic of spinal stenosis with Chiropractic associates. It was on the lips of these docs because they diagnosed and treated it in their daily practice. Nowadays I hear about it regularly from lay friends.
As I age it’s not surprising to hear about spinal stenosis from my peers or contemporaries. It has an aging component and it’s often something that increases as our years increase.
What is Spinal Stenosis?
Spinal Stenosis is the term for a condition in which parts of the spinal column (the collection of bony vertebrae) narrow. More specifically, it’s when there is reduced space at openings made up of vertebral bodies and discs. When these areas shrink, nerves emerging from the holes are compressed.
This is often addressed in chiropractic care. Treatment plans state you are being treated for a “subluxation.” That means there is a small degree of bone out of place, usually, but not always, a vertebra. (‘Sub’ is small, versus a ‘full’ luxation which is a true displacement of bone).
The DC will often explain that this subluxation is pinching a nerve – or compressing it. In common terms, you can think of their “adjustment” to fix this as creating more space in the hole and relieving nerve pressure. Mind you, this is a loose and incomplete description.
While the process is the same, the condition of spinal stenosis can occur in different body regions. You may be diagnosed with “cervical stenosis” (located in your neck, or cervical spine), or “lumbar stenosis” (in the lower back or lumbar spine).
The idea is the same. The holes, which in fancy, arcane medical language are called foramina, have gotten smaller. Nerves leaving the spinal cord at those areas suffer from being slightly, or more-than-slightly, compressed. It’s similar for either region – neck or low back (most often very low back).
Symptoms of Spinal Stenosis
Neuropathy of some type is usually the first alerting sign, or what causes people to reach out for help. There is tingling or numbness in our legs or arms, usually more specifically in our feet or hands/ fingers. This is what gets the attention of the suffer as it’s obviously ‘not right.’
Stiffness or pain in the affected spinal region most likely appeared earlier, but not recognized as a progressing set of symptoms. We often contribute these early signs to various other events. Further complicating our awareness is that resting can often provide temporary relief of these symptoms, thus masking that we indeed have a problem. It allows us to ignore the indications longer.
Neuropathy in the feet can become a noticeable problem when walking or standing (especially for long periods). If it becomes moderate or severe, it’s common to develop balancing difficulties or instability.
What are the Causes?
I hinted at the major cause already – age. More specifically it’s wear-and-tear, or repetitive small damages to our bones that can lead to “bone spurs.” [Yes, bone spurs happen in places other than our heels.] On x-ray, many of us have some spurs, even if asymptomatic. It’s frequent in aging and made worse by previous accidents or injuries to the spine. Wear-and-tear or overgrowth of bone encroaches on those intervertebral holes, diminishing them.
Bulges into these spaces is another common cause. These protuberances come in several categories, such as ligaments thickening with age, and then bulging into the spinal canal. It can be a herniated or bulging disc that takes up too much space in the opening. Further it can happen from tumors in the spine. All do the same thing, even if from diverse causation, and with various degrees of health complications.
Spinal stenosis can also be congenital, but it’s rather rare to be born with it. However, family history can increase the likelihood of developing the condition.
In extreme, or untreated, cases, symptoms can lead to permanent problems. Persistent numbness, tingling, weakness, balance problems or possibly even paralysis in extremely problematic cases. Think of it as a nerve (specifically a nerve controlling these extremities) being so compressed that it no longer functions properly. It can also be more than one nerve area.
How to Know if it’s Spinal Stenosis?
You usually need a professional for an official diagnosis. She may begin to determine the diagnosis by physical exam. Additionally, imaging tests are often necessary.
I mention prevention below; prevention steps are not dangerous whether you have spinal stenosis or not. Yet, with advanced age, you might need a little extra treatment from a professional. For instance, as alluded to above, lots of people find relief of symptoms through chiropractic care or physical therapy. Your goal is to avoid both progression and later risk of surgical procedures for treatment of severe neurological problems.
The most appropriate imaging tests are often determined by the symptoms you’re experiencing and their duration. “Most appropriate” means it fits your level of problem.
Common situations (and mild neuropathy) are diagnosed first by physical examination. This includes observation of how the body moves and whether abnormal developments are noticeable in cervical, thoracic or lumbar areas from physical inspection. X-rays of the spine will reveal changes we mentioned above such as bone spurs or bulges into the intervertebral space. Most of us have some of these indications; they do NOT all cause problems. Your doc will look for signals in the spinal areas that are related to your symptoms.
Severe cases often need more sophisticated imaging, but presumably only after the initial physical exam (which admittedly, some docs skip). An MRI (magnetic resonance imaging) may be used to check bone damage. CT scans can illuminate exactly which area(s) of spinal cord nerves are being compressed. An EEG (electroencephalogram) can help in evaluating the actual current condition of the spinal nerve in question. If surgery is considered, certainly one or more of these tests will be done.
Prevention
Some experts claim that age-related spinal stenosis cannot be prevented. Okay. Maybe. Still many symptoms can be reduced, limited or almost eliminated. You CAN reduce progression.
Prevention tips will sound like some of the normal good-health habits we always hear about. Reminding ourselves of how much value these behaviors have for a variety of conditions might motivate us to follow them more often. Ones closely related to spinal stenosis include:
— Don’t SMOKE – yes, it’s even been linked to this problem.
— Exercise regularly.
— Include some weigh-lifting, either in regular fitness routines or in daily movement. (See recommendations below.)
— While you want to lift some weight, you need to avoid lifting heavy weight objects from the ground. Keep in mind the constant refrain of ‘bend your knees when lifting.’
— Watch your posture when you stand, sleep and especially sit (particularly so if you work long hours at the computer).
— Balanced diets (all vitamins, minerals and normal nutrients of fats, protein and carbohydras are essential). Surprise, surprise (not), fruits and vegetables are always recommended.
— Alcohol, excessive red meat and over-use of caffeine are on the ‘definitely-not-great for me’ list.
— Some people use fat-soluble B-1 (sometimes difficult to find versus the normal water-soluble B-1) for diabetic neuropathy. More evidence of this may be needed, but I point it out because it’s used for a different type of neuropathy than that from spinal stenosis.
More Prevention Through Movement
Range of motion (ROM) is a focus for fitness that helps with spinal stenosis. Gentle ROM movements of either the neck or low back improve flexibly and reduces stiffness.
In Pizzazz-25, we emphasis “balance, stamina and flexibly” all with low impact. These are important components for the patient with spinal stenosis. Additionally, emphasizing fitness or exercises that strengthen the spinal muscles helps reduce neurological symptoms.
There are some movements you may be surprised to hear suggested. One example is the standing lumbar flexion, somewhat similar to the #9 Hamstring Ski Rock in the PizzazzEE program. This is a satisfying exercise for the spinal stenosis patient, doing it for several seconds, held and repeated. It’s imperative to do it gently.
Think of that exercise a bit like an inversion unit table. It’s function (if used carefully) is multi-fold, and one goal is to open up the interverbal foramina (the holes we have been talking about) to allow less compression on the nerves.
Several of our common, traditional exercises are also on top of the list for helping you with this condition (or keeping it in check). Those activities that strengthen muscles while having low impact on the spine and which work our cardiovascular system are vital. Namely, this includes swimming, walking and cycling.
Final Thought
Spinal Stenosis is a condition we may not be able to escape entirely as we age. However, we can certainly work to reduce or even eliminate its symptoms. Neuropathy seems like an ever-growing complaint in our older society. By following a slightly better fitness plan, avoidance or reduction of complications is frequently possible.
We may demonstrate the wear-and-tear of aging around our spine. But we can still Age with Pizzazz by avoiding the symptoms as long as we can, or work to reduce them if they have already taken hold.
Spinal Stenosis is a condition, not a disease. It shouldn’t stop us in our tracks. It CAN, but shouldn’t and hopefully it won’t. As so often, that which is a benefit for this condition is a gain for so much of our body.
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