Canal Stenosis Overview
Canal stenosis is a condition that affects the spinal column. The spinal cord is housed within a space called the spinal canal, which is bounded by the vertebrae of the spine. When the area around the spinal cord narrows, it is referred to as canal stenosis or one of the condition’s several alternative names, such as central stenosis, central spinal canal stenosis or just spinal stenosis. The condition and its underlying causes can produce a number of uncomfortable symptoms. Many patients with spinal stenosis experience pain in the neck or back, as well as pain, numbness, tingling and weakness radiating to other parts of the body. Depending on the exact location of the stenosis, some patients might experience these symptoms in the neck, upper back, arms, lower back, hips or legs. Some patients may, however, experience no symptoms as a result of a narrowed spinal canal.
Conditions causing canal stenosis
There are many spinal conditions that could lead to the development of canal stenosis, including the following:
- Osteoarthritis – This type of arthritis is typically acquired through the natural aging process and involves the degradation of cartilage within joints. Spinal osteoarthritis can cause the spine’s facet joints to become inflamed crowd spaces around the spinal cord.
- Herniated discs and/or bulging discs – When an intervertebral disc bulges and/or herniates, disc tissue may enter the spinal canal, causing stenosis.
- Bone spurs – The body commonly produces bone spurs (enlargements on a bone’s natural structure) as a means to mitigate bone-on-bone friction. In the spine, this friction can happen in several ways. For instance, intervertebral discs can collapse due to age-related degeneration, allowing adjacent vertebrae to move closer together and rub against one another. This prompts the formation of bone spurs that may encroach upon the spinal canal. Additionally, the presence of osteoarthritis means that cartilage has eroded on the spine’s facet joints. Without a soft, smooth coating of cartilage, raw joint ends scrape against each other. This may stimulate the creation of bone spurs, which intrude upon the spinal canal.
These spinal conditions can be diagnosed through a variety of imaging techniques, including X-rays, MRI scans and CT scans. Physicians may also perform strength and reflex tests and take blood to test for other conditions that may cause canal stenosis.
Treatment options for canal stenosis
Patients who have been diagnosed with central canal stenosis should consult their physicians to determine the proper course of treatment. Most patients are advised to follow a conservative, non-surgical treatment regimen consisting of some combination of the following treatments:
- Medication – Many patients find relief from their symptoms by taking over-the-counter pain medications, like acetaminophen, and non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen. In rare cases, pain may not respond to these drugs, and patients
- Physical therapy – Although stretching and exercising won’t permanently reverse canal stenosis, in most cases it is essential to keep the spine moving to ensure that it stays as healthy and flexible as possible. Physical therapy sessions involve performing exercises designed to strengthen the muscles of the back and keep the spine flexible.
- Hot and/or cold therapy – To address the inflammation and pain that can accompany canal stenosis, patients may place ice packs or heating pads (or alternate the two) on their necks or backs. It’s important to follow a physician’s recommendation for how long to leave these items in place, but a general guideline is to apply them for 20 minutes and remove them for 20 minutes. Patients should also place a towel between the ice bag or heating pad and the body in order to prevent potential damage to the skin.
In addition to recommending these techniques, physicians generally suggest that canal stenosis patients make lifestyle adjustments to improve their overall well-being. Although changing one’s lifestyle will not cure spinal stenosis or reverse its effects, making certain adjustments can improve the health of the spine as a whole and potentially help mitigate the symptoms of stenosis. Some commonly suggested changes include:
- Maintaining a healthy weight – Losing excess weight can take some of the burden off the spine and potentially alleviate symptoms, particularly in the case of lumbar spinal stenosis. Extra weight around the belly can place pressure on the already injury-prone lower back area.
- Quitting smoking – Smoking can lead to the breakdown of tissues in the spine, and kicking the habit can help sustain the strength of this important area of the body. This is, of course, just one of many health benefits that patients can gain by stopping smoking.
- Limiting alcohol consumption – Alcohol can impede circulation and relax the muscles that are used to stabilize the spine. Cutting back on drinking can therefore improve circulation around the spine and help the musculature provide better support for affected areas of the neck or back.
- Exercising regularly – Although patients who are experiencing pain and other symptoms caused by spinal stenosis might not feel like exercising, getting up and moving generally improves spinal health. Low-impact activities that gently strengthen the muscles supporting the spine (such as swimming) and increase flexibility (such as stretching) can help.
There are also alternative treatments for canal stenosis that some patients find useful in managing their spinal stenosis symptoms, including:
- Chiropractic care – Based on the thinking that limited spinal mobility and poor alignment can translate to pain and other symptoms, this method focuses on making adjustments to the spine to return it to a full range of normal motion. Such adjustments may include application of manual force or traction to move vertebrae and potentially reduce the pressure on the spinal cord and affected nerve roots.
- Acupuncture – This treatment is based on the belief that life energy (known as qi) flows through the body along meridians, and this energy can be blocked at certain points, potentially causing health problems. Acupuncturists carefully apply small needles to specific areas of the body in order to release this energy. The treatment is said to alleviate pain and improve participants’ overall quality of life.
- Yoga – Yoga postures focus on proper breathing and slow, gentle stretching, which some people find helpful in addressing their canal stenosis pain and other symptoms. It’s important for patients to start slowly and ease their way into simple poses, so that they won’t unintentionally worsen their pain.
In many cases, conservative approaches can help manage the symptoms of canal stenosis, but they aren’t effective in every circumstance. If conservative therapies prove ineffective after several weeks or months, a patient may be advised to undergo spinal surgery. The surgeons of Laser Spine Institute perform minimally invasive surgical procedures to treat the symptoms of canal stenosis. Contact Laser Spine Institute for more information about our outpatient surgical techniques and for a review of your MRI scans.