Spinal Narrowing Overview
Spinal narrowing, which is also known as spinal stenosis (“stenosis” means “narrowing”), can result from injury to the spine, overuse of the neck and back, an inherited condition, or from age-related degeneration of components of the spinal anatomy. A number of anatomical abnormalities can reduce the size of the spinal canal that encases the spinal cord, or of the openings (known as intervertebral foramina) that allow nerve roots to exit the spinal column. Conditions that can crowd spaces in the spine include bone spurs, osteoarthritis, degenerative disc disease and others. Spinal stenosis typically does not exhibit symptoms unless the restricted space leads to irritation or compression of a nerve root or the spinal cord itself. In other words, spinal stenosis itself is not usually considered to be symptomatic; it is the nerve compression and irritation that arise as a result of the stenosis that cause problems.
Who is at risk for spinal narrowing?
Although a neck or back injury can lead to spinal stenosis in people of any age, most spinal narrowing can be found in people who are middle-aged or older. This is because, over the years the spinal anatomy is subjected to a wide range of stress-inducing movement, including bending, twisting and turning. It is these movements that can partially contribute to the anatomical elements in the spine naturally degenerating as an individual ages. The vertebrae, intervertebral discs, ligaments, muscles and joints of the spine naturally begin to wear down and compress, and abnormalities such as bone spurs, herniated discs and ossified ligaments are fairly common results. This natural spinal deterioration tends to contribute directly to the narrowing of the spinal column. Some common risk factors for developing spinal stenosis include:
- Genetics – inherited traits can make certain people more vulnerable to spinal stenosis, and in rare cases, some individuals are born with an abnormally narrow spine.
- Age – people who are 50 or older are more likely to develop stenosis of the spine.
- Obesity – excess body weight places more stress on the spine, which can lead to instability and tissue damage.
- Smoking – ingredients in cigarette smoke can break down tissues in the spine.
- Injury history – a spinal injury that is experienced early in life can affect spinal stability later on.
Symptoms of spinal narrowing
Spinal narrowing doesn’t always produce symptoms. In fact, unless the spinal canal becomes so narrow that it starts to compress the spinal cord (or one of the nerves or nerve roots that branches out of it), the narrowing can go undetected for years.
However, if the spinal canal narrows to the point of spinal cord or nerve root impingement, a person might experience one or more of the following symptoms:
- Localized pain (for instance, if the impingement is occurring in the cervical spine, pain might be felt in the neck; if it is occurring in the thoracic spine, pain might be felt in the central back or torso; if it is occurring in the lumbar spine, pain might be felt in the lower back)
- Pain that travels along the affected nerve (nerves in the cervical spine branch out through the shoulders and arms, while nerves in the lumbar spine branch down through the hips, legs and feet)
- Numbness or tingling in the extremities
- Muscle weakness
- Sciatica (radiating leg pain, numbness and weakness) that occurs only if spinal narrowing causes compression of the sciatic nerve
Patients who do experience these symptoms should meet with their physician for individualized recommendations for treatment.
Treatment for spinal narrowing
Typically, symptoms associated with spinal stenosis can be managed with conservative treatments, many of which can be used indefinitely. These conservative options include:
- Medications – There are many medications that a physician might recommend for a patient with spinal narrowing. Over-the-counter pain relievers (such as acetaminophen) and anti-inflammatory medications (such as ibuprofen) are the most common, although prescriptions can also be written for patients with more severe symptoms.
- Exercise – Walking, swimming and other forms of low-impact exercise can be highly beneficial for reducing pain, while yoga, Pilates and other stretching-based exercises can help patients expand their range of motion. Strengthening exercises can also help enhance the muscles around the spine while promoting better overall health.
- Physical therapy – While a personal exercise regimen is often recommended, physical therapy sessions can also help patients manage the symptoms of spinal narrowing. A trained physical therapist can teach a patient techniques for reducing pain during normal daily activities, as well as exercises that can help improve flexibility and muscle tone.
- Rest and activity modification – When the spinal cord or a nerve root is compressed, certain activities or motions may make pain worse. Avoiding these activities, or modifying the way in which they are performed, can help patients deal with the symptoms of spinal narrowing.
Some patients also pursue alternative therapies, such as chiropractic care, acupuncture, hydrotherapy and therapeutic massage. When provided by a reputable practitioner, these options can help supplement a patient’s conservative treatment regimen. However, while alternative and conservative treatments can provide significant short-term pain relief, these options cannot prevent or reverse spinal narrowing. If a patient’s spinal stenosis continues to get worse — or their symptoms continue to progress — surgery may be necessary to create additional space in the spinal canal.
Surgery for spinal narrowing
If chronic neck or back pain persists despite exhaustive conservative treatment, surgery may become an option. A surgeon will evaluate each patient’s condition to determine if an operation is the best option for creating more space in the spinal canal, or to decompress an affected nerve.
At Laser Spine Institute, several minimally invasive surgical options are available for patients with spinal narrowing. Our surgeries are performed on an outpatient basis and have several other advantages over traditional open neck or back operations. Several different techniques are offered at Laser Spine Institute, depending on the location and severity of the patient’s spinal stenosis, and a number of other personal factors.
To learn about the many advantages of our minimally invasive, outpatient procedures, which are performed with state-of-the-art technology, contact Laser Spine Institute today.