If your back began hurting after you turned 50, then you may be experiencing spinal stenosis.
It’s a condition that occurs when your spinal canal starts to narrow, exerting pressure on the spinal cord and associated nerves. Stenosis most commonly appears in the lower back or neck.
Symptoms can include pain, numbness, and tingling. You may also feel weakness in your legs and arms.
Stenosis usually develops gradually, and the symptoms come and go. They may be worse during some activities, like walking or standing upright.
A 2017 study1 indicated that certain genetic changes are linked with an increased risk of developing lumbar spinal stenosis
With a better understanding of the condition and the identification of genetic markers, individuals who are at increased risk can be identified early and preventative measures can be initiated. The information may also help investigators develop more novel and precision-based management options for affected patients,
said senior author Dr. Dino Samartzis.
There is no currently cure for stenosis, but there are effective medical treatments and self care methods.
Medical Treatment For Spinal Stenosis
First, get diagnosed by your physician. If your doctor suspects you have stenosis, they’ll begin with taking your medical history. They’ll also do a physical exam, and order X Rays and other imaging tests.
Take medication. Your doctor may recommend a variety of drugs. If over the counter pain remedies are inadequate, a short-term course of prescription pain relievers or steroid injections could help while you learn other coping strategies.
Patients with spinal stenosis (SS) experienced good short term benefit, lasting from weeks to months, after receiving epidural steroid injections, a letter in the journal Pain Medicine found. Those findings contradict a previously published New England Journal Medicine study2 that found epidural steroid injections were not helpful in spinal stenosis cases.
Start physical therapy. Most patients with stenosis benefit from working with a physical therapist. You may need only a few sessions to learn exercises that you’ll be able to continue doing at home on your own.
Ask about alternative therapies. Let your doctor know if you’re interested in acupuncture, massage, or seeing a chiropractor. They can help you understand how these options might work for you and coordinate your overall care.
Consider surgery. If your symptoms are severe, you may need to decide whether to have an operation. Your doctor can explain your choices, including a laminectomy to remove some portions of the affected vertebrae or less invasive procedures.
In cases of degenerative spondylolisthesis with spinal stenosis, a condition that affects six times as many women as men and is especially prevalent among African-American women, surgery was twice as effective as non-surgical approaches in reducing pain and restoring functionality for patients. This was one of the findings of the Spine Patient Outcomes Research Trial (SPORT), a seven-year, $21 million national study funded by the National Institutes of Health.
Seek urgent care. In rare cases, stenosis patients may develop cauda equina syndrome that poses a risk for permanent nerve damage. Call 911 or go to an emergency room immediately if you lose bladder or bowel control, or your pelvic area becomes numb.
Self Care and Lifestyle Changes
Adjust your posture. Keeping your back straight when you sit and stand can help prevent stenosis. If you already have symptoms, leaning forward may ease your discomfort.
Lose weight. Any extra pounds put more stress on your spine and the rest of your skeleton.
Talk with your doctor about how to reach a healthy weight for you. That might mean consuming more whole foods and fewer empty calories. Small changes to your diet can make a big difference over time.
Apply heat and cold. Ice packs and heating pads are a simple way to achieve quick relief. Hold them on the sore area for about 20 minutes at a time.
Use assistive devices. You may find it difficult to walk if your stenosis becomes advanced. Products like corsets, braces, and walkers can be helpful. Follow your doctor’s recommendations to avoid overuse that could further weaken your spine.
Remain active. It’s natural to be hesitant about working out when you’re already feeling under the weather. However, protecting your mobility will keep you stronger and fitter in the long run.
Along with the exercises you learn in physical therapy, you may want to try cycling and thalassotherapy (swimming in the sea). Be sure to take rest days when you need them.
Jason Pui Yin Cheung, Patrick YP Kao, Pak Sham, Kathryn SE Cheah, Danny Chan, Kenneth MC Cheung, Dino Samartzis. Etiology of Developmental Spinal Stenosis: a Genome-Wide Association Study. Journal of Orthopaedic Research, 2017; DOI: 10.1002/jor.23746 ↩︎
Janna L. Friedly, et al. A Randomized Trial of Epidural Glucocorticoid Injections for Spinal Stenosis. New England Journal of Medicine, 2014; 371 (1): 11 DOI: 10.1056/NEJMoa1313265 ↩︎