If you have been diagnosed with spinal stenosis, don’t panic. It is actually common to develop over time, primarily due to degenerative changes in the discs, ligaments, and vertebrae that make up the spine. Generally, a herniated disc, osteoarthritis of the facet joint, hypertrophy of the ligamentum flavum, or inflammatory changes can cause this condition. While the symptoms are similar, it’s important to note that there are significant differences between herniated discs and spinal stenosis, not only in their causes, but, more importantly, in their treatment.
More than just Back Pain
Around age 50, the spinal canal, through which the nerves pass (the spinal cord from the skull to L1L2 or the cauda equina from L1-L2 to the sacral region), narrows slightly. However, when this narrowing worsens due to more significant degeneration of the spinal structures, it is called spinal stenosis.
In the United States, the prevalence of spinal stenosis is around 11% in adults and increases with age. Generally, stenosis occurs as the body’s response to contain initial disc degeneration. Over time, this attempt leads to hypertrophy, or thickening, of the spinal structures (facet joints, ligaments, discs, bones, etc.), and all these tissues, now thicker or deformed, can cause nerve compression by closing and narrowing the spinal canal.
How Is Spinal Stenosis Different from a Herniated Disc?
Pain and numbness in the spine and limbs are some of the main symptoms. Unlike those of a herniated disc, the symptoms appear gradually over the years and progressively worsen. Furthermore, unlike a herniated disc, where pain is usually unilateral, the symptoms of spinal stenosis are typically bilateral and are associated with difficulty walking (neurogenic claudication), with loss of strength and balance.
Another important point is that a herniated disc is an acute event, more common in young adults, due to a problem with the disc. In spinal stenosis, the narrowing of the spinal canal is not solely due to a problem with the discs, but rather to various structures in a vertebral segment, such as discs, bones, and ligaments. The most affected age group is 50 years and older.
The diagnosis should be made by a physician, preferably a spine specialist, through medical history, physical examination, and imaging tests, such as X-rays, computed tomography (CT) scans, and primarily magnetic resonance imaging (MRI), which is the most appropriate test for this condition.
Related content: Spinal Stenosis
Treatment Options
Treatments must be tailored to each patient, as spinal stenosis often causes problems beyond those affecting the spine. Several conservative treatment methods and minor surgical procedures are available and can be performed safely.
Conservative (Non-Surgical) Approaches
For less severe cases, conservative treatments may include:
- Physical therapy: Exercises to strengthen the lower back muscles and increase flexibility, thus relieving pressure on the nerves.
- Medications for pain and inflammation: pain relievers and anti-inflammatories help control symptoms.
- Corticosteroid injections: Injections into the affected area temporarily relieve pain and inflammation, allowing patients to resume their activities.
Surgical Treatments
Surgery may be indicated when symptoms worsen and significantly affect quality of life. Among the modern, less invasive alternatives is lumbar endoscopy, which allows for nerve decompression through much smaller skin incisions. This technique minimizes surgical trauma, accelerates recovery, and produces less postoperative pain than traditional surgeries.
Get an Individualized Treatment at Space City Pain
Spinal stenosis is curable, provided it is diagnosed early. Treatment should be individualized, beginning with conservative measures and, when necessary, resorting to decompressive surgery, which can be performed in a traditional way or endoscopically, depending on the medical indication.
At Space City Pain Specialists, we provide a safe and supportive environment so you can live without pain and move with greater freedom and confidence. Our doctors are experts in patient care and ensure that they listen to and address every concern with respect. Our unique philosophy is to address the root cause of pain rather than simply relieving symptoms. If you are experiencing symptoms of spinal stenosis, it is crucial to seek specialized help and discuss the best treatment approach.
