The spine is an amazing combination of bones, ligaments, disks, joints and nerves all working in unison so you can walk, jump, bend, run, dance, turn, twist and move around. Under ideal conditions all the parts of the spine work together without any problems or causing discomfort. But for people with spinal stenosis, pain or leg cramping can become a frequent occurrence. I caught up with R. Peter Mirkin, MD, board certified orthopedic spine specialist on staff at Des Peres Hospital, for more details.
"Spinal stenosis causes a narrowing of the small spinal canal, putting pressure on the nerve roots and spinal cord resulting in lower back and leg pain," said Dr. Mirkin. "Common symptoms include cramping, pain or numbness in the legs, back, neck, shoulders or arms, or a loss of sensation in the extremities. Most cases of spinal stenosis are caused by osteoarthritis, although spinal tumors, herniated disk, ligament changes, trauma or previous surgery can cause the condition as well. The risk of developing spinal stenosis increases for people who were born with a narrow spinal canal, and are over the age of 50 or female."
Dr. Mirkin said diagnosing spinal stenosis can be challenging because signs and symptoms tend to be sporadic and may mimic those of other age-related conditions. Your doctor will typically take a medical history and perform a physical exam. Additional tests can be done to verify and evaluate the diagnosis. These test may include a spinal X-ray to check for skeletal abnormalities, a computed tomography scan to assess the spinal canal, a magnetic resonance imaging scan to take pictures of the spinal cord or nerves, or a myelogram (an X-ray that uses an injection of contrast dye) to show herniated disks, bone spurs or tumors.
Although there is no cure for spinal stenosis, Dr. Mirkin said different treatments are available.
"Non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen can help reduce inflammation and pain," said Dr. Mirkin. "Analgesics like acetaminophen can be taken to treat pain. Non-prescription supplements including chondroitin sulfate and glucosamine have shown to have positive effects on spinal stenosis, but may interfere with other medications. Physical therapy can help build strength, increase endurance, and maintain spinal flexibility. Wearing a brace or corset may be recommended for people with weak abdominal muscles. Epidural steroid injections may provide significant relief for leg pain."
When non-surgical treatments are no longer effective, surgery may be necessary. Dr. Mirkin explained that during a decompression laminectomy, bone spurs that have built up in the spinal canal are removed, making more room for nerves and the spinal cord. In some cases, a spinal fusion procedure may be performed concurrently to provide more spinal support; or the surgery may be performed on its own. Symptoms may recur or worsen over time because surgery does not halt the degenerative process of spinal stenosis.
Dr. Mirkin noted that some age-related changes cannot be avoided, but you can take steps to protect your spine and keep joints as healthy as possible.
"Exercise regularly to help maintain strength and flexibility. Stay within a normal weight range to reduce stress on joints and bones. Employ proper body mechanics to keep your back healthy," he recommended.
For more tips on keeping your back healthy, visit http://despereshospital.staywellsolutionsonline.com/Wellness/BackandNeck/Healthy/