Spinal Stenosis is a common and potentially crippling condition affecting most of us to some extent as we get older. It can occur anywhere in the neck, middle, or lower spine. Although there are many types and causes of spinal stenosis, the most common occurs over the age of 60, affecting women slightly more than men. We all will to some extent develop a degree of spinal stenosis as part of the normal aging process.
However, most of us will not be aware of this potential problem. However, once it becomes symptomatic, it is difficult to alleviate the symptoms completely.
You can think of spinal stenosis as “angina of the spine”. In spinal stenosis, the spinal canal becomes narrowed to the point that the micro-circulation to the spinal cord and spinal nerves are compromised. This causes a variety of symptoms including back pain, sciatic nerve pain, numbness, weakness, balance problems, a flexed forward posture, difficulty walking any distances, and/or any combinations of these. In severe cases, muscle atrophy along with bowel and bladder disturbances may develop. Spinal stenosis is also called the great masquerader since it can mimic several other conditions such as peripheral vascular disease, neuropathy, large joint problems, or central nervous system disorders.
The causes of spinal stenosis are several including arthritis of the spine, degenerative disc disease, disc herniation, enlargement of soft tissue structures inside the spinal canal, facet joint cysts, inflammatory and post surgical scar tissue, spine fractures, and certain deformities of the spinal column. Typically, it is a combination of these factors. Other factors that can contribute to symptomatic spinal stenosis include obesity, poor nutrition, lack of exercise, smoking, and certain medical condition such as diabetes, cardiovascular disease, osteoporosis, and thyroid disorders.
Most cases of spinal stenosis can be managed without surgery. Further, a comprehensive and multidisciplinary treatment plan that looks at the patient as a whole will produce the best and most lasting results. This is especially true in an aging population where maintaining an active lifestyle is important for ongoing general health and well-being. Spinal stenosis is a very crippling problem, but a very treatable problem.
A recent government study looked at the condition of symptomatic spinal stenosis and the various treatment approaches including oral medications, physical therapy, pain management, and surgery. The study (called the SPORT, or, Spine Patient Outcomes Research Trial ) was carried out at 13 centers in 10 states and involved twenty five hundred patients over a five year period of time. The study was published in the New England Journal of Medicine and subsequently in the Wall Street Journal and was covered on ABC News in the spring of 2008. The results were conclusive that surgery offered the best short and long term results in alleviating pain and returning patients to an active lifestyle including many recreational sports at all ages.