Spinal Stenosis: Causes, Symptoms & Treatment in Delhi

Spinal Stenosis

Spinal stenosis causes narrowing of the space in the spine. It leads to compression of the nerve fibres in the spine canal. The lower back and the neck are the most commonly affected areas for spinal stenosis.

Associated Anatomy

Spinal cord

Causes

Some of the most common causes of spinal stenosis are:

Wear and tear of the vertebrae (bones that surround the spinal cord) due to osteoarthritis, which can cause an overgrowth of the bones.
Paget’s disease, a disorder that affects the bones of adults, can also cause deformation of the bone in the spine, causing spinal stenosis.
Herniated disks (rubbery cushion between the vertebral bones pushes out and cause pressure on the nerves)
Ligaments get thickened over time and become stiff. These thick ligaments can bulge into the spinal canal and cause spinal stenosis.
Abnormal growths and tumours inside the spinal cord can cover the space between the spine and vertebrae and cause spinal stenosis. These are uncommon.
Injury to the spine, such as accidents, can lead to dislocation of the vertebrae, which can cause damage/pressure on the spinal cord and the nerves.

Signs Or Symptoms

Symptoms of spinal stenosis depend on the areas of the spine that are involved.

If spinal stenosis occurs in the lower back (lumbar) area, then the symptoms include:

Pain in that region
Sciatica - pain that starts at the gluteal region and goes down to the leg
Numbness or tingling
Weakness of the leg or foot
Pain that worsens during activities like walking
Loss of the bladder or bowel movements (in rare cases)

If it occurs in the neck or cervical area, then the symptoms include:

Neck pain
Weakness and numbness in the arms, hand, leg, or foot
Pain radiating from the neck to the arm or shoulder
Balancing problems in galt.
Problems with daily tasks such as writing, buttoning a shirt, etc.

Possible Treatment

Physical therapy to improve flexibility, endurance, balance and overall movement.
Exercises specific to spinal stenosis, such as stretching, aerobics, etc., can strengthen the muscles that support the spine.
Medications such as NSAIDs and other painkillers can help with managing the pain.
Sometimes with non-surgical methods may not provide significant or lasting relief of the symptoms.

People more at Risk In those cases, surgical decompression may be required after consultation with your spine specialist.

People over the age of 60.
If spinal stenosis happens in younger people, it probably is due to other additional causes.
Trauma
Genetic conditions that affect the bone and muscle development all over the body
Congenital spinal conditions such as short pedicles.

Typical Test

Some of the standard tests the doctors advise before confirming the diagnosis of spinal stenosis include X-rays, Magnetic Resonance Imaging (MRI) or Computerised Tomography (CT), etc. These tests are done to check for any changes in the bones or narrowing of the space in the spinal canal, damage to the vertebral dicks and ligaments, presence of any abnormal growths like tumours, compression on the nerves, herniated disks, etc.

Primary Prevention

Most people experience some kind of wear down of the bones by the age of 50. A few things we can do to prevent the early occurrence of spinal stenosis are:

Exercise regularly, which will strengthen the muscles that support the vertebrae and spinal cord and help keep the spine flexible. Exercises such as swimming, walking, cycling, etc., are good for the back muscles.
Maintain a healthy weight. It prevents excess weight on the back, contributing to the lower back spinal stenosis.
Maintaining good posture is essential.

Secondary Prevention

Try to sleep on a firm mattress.
Use chairs that support the natural curves of the spinal cord and vertebrae.
Learn to lift heavy objects safely.
Maintain flexibility in the spine.

Additional Type

There are generally two types of spinal stenosis. One is foraminal stenosis, also known as lateral stenosis. It causes the compression or inflammation of nerves coming out of the spinal cord. The other type of spinal stenosis is central canal stenosis, which causes the compression of the spinal cord/ sac of spinal nerves.

Differential Diagnosis

Differential diagnosis of spinal stenosis include Peripheral Vascular Disease (problems with blood vessels), Cauda Equina Syndrome (compression of the nerves at the bottom of the spinal cord), and other nonspecific reasons for low back pain.

Epidemiology

A few studies have shown that at least 20 percent of the elderly population in India are suffering from spinal stenosis.
The prevalence can be increased in future due to many metabolic conditions such as obesity.
Also, the number can be varied since many people are asymptomatic and are not yet diagnosed.

Expected Prognosis

In most cases, the expected prognosis for spinal stenosis is good. Patients suffering from pain and other signs and symptoms can benefit from various non-surgical treatments. However, in some severe cases, surgery can be a good option.

Natural Progression

Symptoms of spinal stenosis can often get worse over time, but it happens slowly. As the symptoms such as pain get worse or loss of movement occur, medications are probably not enough. In such a case, surgery is probably needed to relieve the pressure on the nerves or spinal cord.

Pathophysiology

Spinal stenosis is related to spinal cord dysfunction caused by compression and degeneration of the nerve fibres. With ageing, the vertebral discs degenerate, causing excess bone growth that commonly occurs in the cervical and lumbar regions of the spinal cord.