Spinal stenosis: symptoms, causes and how to treat it

Definition of spinal stenosis

What is spinal stenosis?

Spinal stenosis is a condition in which one or more spaces inside the spine are narrowed. Narrowing of the space within the spine in the bone structure can limit the space available for the spinal cord and nerves that branch from the spinal cord.

This narrow space will cause the spinal cord or nerves to become compressed (pinched) and eventually become irritated. This condition will later cause various disturbing symptoms.

Types of spinal stenosis

This narrowing of the spine can occur anywhere in the spine. However, it most commonly affects the upper and lower parts of the body. Therefore, in general, spinal stenosis is divided into 2 types, namely:

• Lumbar spinal stenosis

Lumbar spinal stenosis is a narrowing of the space in the lower spine, called the lumbar. People with this condition may experience problems with the limbs of the lower body, such as the legs.

• Cervical spinal stenosis

Cervical spinal stenosis is narrowing of the space in the upper spine near the neck. People with this condition may experience problems with the neck and limbs in the upper body, such as the hands.

How common is this disease?

Spinal stenosis is a common musculoskeletal disorder. In most cases, this disease affects more people over 50 years of age.

Signs & symptoms of spinal stenosis

Space narrowing in the spine in the early stages of development, often causes no signs and symptoms. The process of refinement is slow so it will worsen over a long period of time.

So, someone who feels mild symptoms at first, does not realize the condition is spinal stenosis and lets it be, of course, the symptoms will get worse over time.

Symptoms of spinal stenosis vary from person to person. It also depends on which area of ​​the spine is affected.

More specifically, here are the symptoms of spinal stenosis that may occur depending on the area of ​​the spine that is affected:

Lower back pain, buttocks to legs

Common back pain is described as pain from electric pressure, pinching, or a burning sensation. Pain can appear suddenly and disappear on its own, but it is persistent.

Apart from the back, pain also appears in the buttocks and can spread to the legs. This pain in the back, buttocks and legs usually gets worse when you stand for long periods of time, walk, and go down stairs.

The pain will improve slightly when you lean back, stand slightly bent forward, walk up or down stairs, and sit down. This is the most common symptom of lumbar spinal stenosis.

Pain is also a symptom of cervical spinal stenosis. However, areas that cause pain or pain in the neck. While the narrowing that attacks the middle (thoracic) spine will cause pain in the middle back area.

Muscle and nerve problems

Other symptoms of spinal stenosis that commonly accompany are numbness, tingling, and weakness in the limbs.

If cervical spinal stenosis affects the hands, while lumbar spinal stenosis affects the legs. This weakness in the legs can also disturb the balance of the body.

This condition makes it difficult for sufferers to carry out daily activities, for example, it is difficult to write, walk, or button a shirt.

Other symptoms of spinal stenosis

In severe cases, people with this condition also experience problems controlling the bladder and decreased libido.

When to see a doctor?

If you have any signs or symptoms above or any other questions, please consult your doctor.

Everyone's body is different. Symptoms that appear between you and others may be different. Consult a doctor for further treatment.

Causes of spinal stenosis

The narrowing of the space in the spine is caused by many things. Even so, all of them have something in common, namely changing the structure of the spine, causing the space around the spine to narrow.

The various causes of spinal stenosis that you may have are:

Excessive bone growth

Inflammation of the bones, such as osteoarthritis, can damage the cartilage in the joints including your spine. Cartilage is the barrier covering the joints. When the cartilage weakens, the bones start rubbing against each other so that the body responds to grow new bone.

This new overgrowth of bone (bone spurs) that occurs around the spine can expand and narrow the space in the spine and pinch nerves in that area.

Paget's disease of the bones can also cause an overgrowth of the spine that can compress the nerves.

Paget's disease of the bones can also cause an overgrowth of bone in the spine, pressing on the nerves.

Herniated disc

In each vertebra (the bone that forms the back) there is a spherical bearing called a vertebral disk.

As you age, the vertebral disk will experience cracks in the outer edge which causes special fluid from this disk to penetrate the weak outer layer. The disc will bulge, taking up space in the spine and pressing on the nerves near the disc.

Thickening of ligaments

Ligaments are bands of fibers that hold the spine together. Arthritis can cause ligaments to thicken over time so that they take up space so that narrowing can occur.

Fracture or injury to the spine

Broken bones, sprains (sprains), or inflammation that occurs near the spine can narrow the canal space and put pressure on the spinal nerves.

Tumor

Abnormal tissue growths in and between the spinal cord or on the spine itself can narrow space and irritate surrounding nerves.

Risk factors for spinal stenosis

There are several factors that can increase the risk of space narrowing in the spine, including:

• Born with a narrow spinal canal.
• This disease often affects women than men.
• Over 50 years of age.
• Have had a previous spinal injury or surgery.
• Born with a genetic disease that can affect the development of bones and muscles throughout the body.
• Have spinal disorders from birth, such as scoliosis (the spine that curves sideways to form an S or C).

Diagnosis & treatment of spinal stenosis

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

It is difficult to identify the space in the spine because the symptoms that appear can be similar to signs of other health problems. To diagnose spinal stenosis, your doctor will ask you to undergo a series of medical tests, such as:

• Physical examination

The doctor will examine the area of ​​the spine that is causing symptoms and take a medical history of your body.

• X-ray imaging test

This medical test can help doctors see bone changes, such as the presence of bone spurs (abnormal bone growths) that narrow the space inside the spinal canal.

• MRI imaging test

The medical test uses magnets and radio waves to produce cross-sectional images of the spine. That way, it can detect damage to a disk or ligament, as well as pinpoint areas of the nerve that are under excessive pressure.

• CT myelogram test

If you are unable to have an mRI test, you will be asked to undergo this medical test. You are injected with a special dye which then flows into your spinal cord and nerves. With this dye, doctors can detect hernias, bone spurs, and tumors in the spine.

How to treat spinal stenosis?

Treatment for spinal stenosis will depend on the severity of the condition and the location of the affected bone. More clearly, how to treat spinal stenosis, both lumbar and cervical types are:

Take medicine

Reporting from the Mayo Clinic website, some of the drugs doctors prescribe to treat spinal stenosis are:

• Pain relievers such as ibuprofen or acetaminophen. If this does not work, the doctor will prescribe another drug that is stronger in effect, such as the antidepressant drug amitriptyline.
• Anti-seizure drugs such as gabapentin (Neurontin) and pregabalin (Lyrica) to reduce pain caused by damaged nerves.
• Opioid drugs such as (Oxycontin, Roxicodone) and hydrocodone (Norco, Vicodin) can be used in the short term to reduce pain. However, its use must be based on a doctor's prescription.

Physical therapy

These musculoskeletal disorders can render the body inactive. Instead of preventing the pain from recurring, being inactive can actually make the muscles weaker, and even make the pain worse.

Therefore, physical therapy is needed as part of the treatment of spinal stenosis. The goal is not only to reduce symptoms, but to help build bone resistance, maintain bone flexibility and stability.

Steroid injections

A nerve root that is irritated and swollen at the pinched area can cause severe pain. If you experience, the doctor may inject steroids. Although it doesn't cure spinal stenosis, it can help relieve symptoms.

Unfortunately, this treatment is not effective for everyone. In addition, repeated injections can weaken the bone and surrounding connective tissue. Therefore, you can only get this injection a few times a year.

Decompression procedure

This procedure uses a needle to partially remove the thickened ligament at the back of the spine to provide additional space and relieve pressure on the nerve roots.

However, this treatment is more for lumbar spinal stenosis patients who are at high risk of undergoing surgical operations.

Operation

If the above treatments are not effective in treating spinal stenosis, surgery will be performed. Several types of surgery are performed to treat spinal disorders, including:

• Laminectomy. This medical procedure removes the back (lamina) of the affected vertebra. Sometimes this treatment is also called decompression surgery because it aims to reduce pressure on the nerves.
• Laminotomy. This procedure only removes part of the lamina, by making a large enough hole and reducing the pressure at a certain point in the area.
• Laminoplasty. This procedure is performed to open the space in the spinal canal around the neck by making a hinge on the lamina. The metal hardware will be placed in the exposed part of the spine.
• Minimally invasive surgery. This surgery removes the bone or lamina in a way that reduces damage to surrounding healthy tissue.

In most cases, this spatial surgery helps reduce the symptoms of spinal stenosis. However, some people still feel the same or even worse symptoms after surgery.

The side effects of this treatment are infection, tear in the membrane covering the spinal cord, blood clots, or nerve damage.

Home remedies for spinal stenosis

What are some lifestyle changes or home remedies for spinal stenosis?

Apart from doctor's medication, spinal stenosis also needs home remedies to help relieve symptoms while reducing their severity, such as:

• Take pain relievers

The pain that appears can be relieved with over-the-counter drugs, such as paracetamol, ibuprofen, and naproxen. Although quite safe, to be safer to use, do not hesitate to consult a doctor.

• Ice or hot water

In addition to taking pain relievers, you can also use ice packs or hot water to reduce pain. However, make sure not to apply the compress for more than 15 minutes to your skin.

• Lose weight

If you are overweight, your doctor may recommend that you follow a diet to make your weight more ideal. The goal is to reduce stress and pressure around the spine.

• Use a cane or walker

If you have balance problems that make it difficult for you to walk properly, using a cane or walker can make it easier for you to move around.

• Regular exercise

Symptoms that arise can reduce body mobility. Therefore, follow a routine exercise that is guided or directed by a therapist.

Prevention of spinal stenosis

Most cases of spinal space narrowing are caused by age-related decline in bone health. Therefore, there is no 100% way to prevent this disease.

Although not completely prevented, there are several ways that can help you reduce your risk or slow the progression of spinal stenosis, namely:

• Eat a healthy diet and maintain an ideal body weight.
• Quit smoking and avoid secondhand smoke.
• Get used to good posture, such as sitting, standing, and walking upright.
• Get some exercise to help stabilize your ideal body weight while keeping your muscles and bones healthy.