Degeneration can lead to a narrowing of the spinal canal. This narrowing can lead to low back pain, numbness in the arms or legs, and weakness. Stenosis often feels better when bending forward, and those suffering from it can have a forward-leaning, shuffling gait. There is no conservative cure for stenosis, but chiropractic care helps.
Care for Spinal Stenosis
What is Spinal Stenosis?
A Narrowing of the spinal canal sometimes puts pressure on the nerves. It may or may not result in neck pain, low back pain, limping, and a lack of feeling in the arms or legs. This is often a degenerative condition. It may exist for years without causing pain or discomfort, but a fall or an accident can trigger characteristic stenotic pain.
Numerous other factors can cause stenosis, such as thickened ligaments, expanding infection, abscess, a congenital or developmental anomaly, vertebral fractures or dislocations, or a spinal cord tumor.
Other conditions, such as a herniated disc, can mimic stenosis. While herniated discs usually cause rapid and acute muscle spasms, discomfort caused by stenosis builds gradually. Other conditions that can be confused with stenosis include vascular claudication, peripheral vascular disease, and abdominal aortic aneurysms.
Claudication—pain triggered by walking—caused by vascular disease most often occurs after walking a fixed distance. Patients with spinal stenosis, however, walk variable distances before symptoms set in. Activities like riding a bicycle and walking up a hill can cause pain in patients with vascular claudication, but not in those with stenosis. Standing makes pain worse for stenotic patients, while it relieves vascular claudication.
There are three basic treatment approaches to spinal stenosis:
- The conservative medical approach, which frequently involves bed rest, analgesics, local heat, and muscle relaxants
- The conservative chiropractic approach, which includes manipulation, exercise and self-care techniques
The cause of the stenosis dictates the treatment. Although medications can provide pain relief, those powerful enough to deaden the pain can also exacerbate a patients’ already compromised sense of balance. When the patient loses bowel or bladder control, suffers from intolerable leg pain and claudication, and has progressive loss of function or spinal cord tumors, surgery is the first and only option.
The standard surgical procedure usually involves opening up the spinal canal and decompressing the neural elements by removing the bony structures that contribute to canal narrowing. Although many patients do fairly well after the surgery, the symptoms are likely to return after a period of time.
Recent studies show that although surgery will often have good results for up to two years, in the long run, outcomes are much the same between surgery and conservative care. Some surgeries have to be repeated years later.
In many mild and moderate cases of stenosis non-invasive conservative care, such as chiropractic, can help lessen pain and discomfort, maintain joint mobility, and allow the patient to maintain an active lifestyle. A technique called distraction manipulation may be helpful in reducing leg discomfort. Home exercises are a major part of the conservative treatment program.
It is recommended to exercise four or five times a week with physical activities such as riding on the bicycle or lying on the side and grasping the knees with the arms, focus on flexing the spine in a forward position—stretching and strengthening the lower back and stomach muscles and improving muscle strength. Exercises designed to mobilize the involved nerves have been found to be particularly helpful.
Ultimately, stenosis is a chronic condition that cannot be “cured,” but it often can be improved, and improvement can be maintained over the long term. Patients can work with a health care provider, such as a doctor of chiropractic, to reduce symptoms and improve their quality of life.