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Spinal Stenosis

Spinal Stenosis is a condition caused by narrowing of the spaces in the spine resulting in pressure on the nerve roots The diagram below shows the vertebral body and its associated structures. The spinal cord passes through the vertebral foramen while the spinal nerve roots exit on the side by the pedicles.  Degenerative disc disease causes excess bone growth called osteophytes which form on the bodies and pedicles.  This causes blockage to the spinal canal and nerve roots.  Some people are born with a narrow canal,they have congenital stenosis..  If there is a disc that is herniated this coupled with degenerative stenosis makes the canal smaller still,this is referred to as acquired stenosis.

    If the pressure is on the lower part of the spine it will cause symptoms in the back, hips or legs. The leg pain of spinal stenosis is intermittent and referred to as claudication. because it also has symptoms of cramping not usually seen in sciatica  The pain of claudication can be in one or both legs.  It is aggravated by walking or standing for long periods of time. Flexing the spine forward relives the pain while extending the spine aggravates it. Pressure on the upper spine will cause symptoms in the neck, shoulders or arms.

Stenosis  is most common in men or women over 50 but can occur in younger people if they were born with narrow spinal canals.  While the most common causes are arthritis and disc syndromes , trauma, tumors or Pagets disease are more rare causes of stenosis.

Treatment of spinal stenosis is aimed at relieving symptoms by reducing swelling on muscles irritated by nerve pressure and traction techniques are also utilized to remove nerve pressure that occurs.  Exercise is usually prescribed and very beneficial for alleviating long term symptoms. Sometimes the use of a back support is warranted.

Surgery may be warranted if compression on the spinal cord causes bowel and bladder dysfunction, this is a medical emergency.  However is most causes conservative care as described above can bring about relief .

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