Spinal Stenosis - Symptoms, causes and treatment

Spinal stenosis is a condition when there is a narrowing of the spinal columnThis puts pressure on the spinal cord. Spinal stenosis most commonly occurs in the lower back and neck.

In the vast majority of cases, spinal stenosis affects people over the age of 50, although this condition can actually be experienced by anyone of any age.

Spinal stenosis is a condition that needs to be treated immediately. The reason is that spinal stenosis that does not get fast and proper treatment has the potential to cause a number of serious complications. One of them is paralysis.

Causes of Spinal Stenosis

As we age, tissue changes occur throughout the body, including the spine. The spinal tissue, such as the ligaments, begins to thicken and the bones become larger, compressing the spinal nerves.

In addition to aging, spinal stenosis can also be caused by the following conditions or diseases:

  • Abnormal bone growth

    Bone spurs and Paget's disease are some of the conditions for abnormal bone growth that can narrow the vertebrae and put pressure on the spinal nerves.

  • Spinal bearing herniation

    With age, the walls of the spinal cord become weaker. When this happens, the spinal discs can protrude, compressing the spinal nerves.

  • Tumor

    Tumors can appear in the spinal cord, precisely within the membrane that lines the spinal cord or in the space between the nerves and the vertebral column. This condition causes the vertebrae to narrow and press on the spinal nerves.

  • spinal injury

    Dislocations, fractures, fractured bones, and swelling of the tissues in the spine caused by injuries, such as accidents, can also cause spinal stenosis.

Risk factors for spinal stenosis

In addition to some of the causes above, there are a number of factors that can increase a person's risk of suffering from spinal stenosis, namely:

  • Aged 50 years and over
  • Having a spinal deformity since birth
  • Had a previous spinal injury
  • Suffering from scoliosis

Symptoms of Spinal Stenosis

In the majority of cases, spinal stenosis causes no symptoms at first. Symptoms usually appear as the condition worsens.

Symptoms experienced by each patient can vary, depending on the location of the narrowing. The following are some types of spinal stenosis and their symptoms:

Neck Stenosis (cervical stenosis)

Cervical stenosis is a narrowing of the cervical spine. Symptoms that can appear are:

  • Numbness or tingling in the hands, arms, feet, or soles of the feet
  • Weakness in the hands, arms, legs, or soles of the feet
  • Neck pain
  • Disturbed body balance
  • Loss of ability to move hands, for example writing

Lumbar Stenosis (lumbar stenosis)

Lumbar stenosis is a narrowing of the spinal column in the lower back. Symptom lumbar stenosis can be:

  • Numbness or tingling in the legs and feet
  • Weakness in the legs and feet
  • Lower back pain (low back pain)
  • Pain or cramping in one or both legs when standing for long periods of time or when walking

In cases of spinal stenosis that are severe enough, lumbar stenosis can cause other symptoms, namely loss of the ability to hold urination or defecation.

When to go to the doctor

Check with your doctor if you experience the complaints and symptoms as mentioned above. Prompt treatment is necessary to prevent complications.

Immediately consult a doctor if you start to have trouble walking and can't hold your urine or bowel movements.

If you have been diagnosed with spinal stenosis, have regular check-ups with your doctor. In addition to monitoring the results of therapy, this routine examination also aims to reduce the risk of complications.

Spinal Stenosis Diagnosis

To diagnose spinal stenosis, the doctor will ask questions about the symptoms experienced and the patient's medical history. Then, the doctor will perform a physical examination, such as measuring the patient's ability to move the hand if the patient is suspected of having neck stenosis.

In order to make the diagnosis more accurate, the doctor will also carry out supporting examinations, such as:

  • X-ray, to detect changes in the spine, such as the occurrence of bone spurs that narrow the vertebrae
  • MRI, to detect damage to the spinal ligaments or cushions, and to detect tumors and parts of the spinal cord that are under pressure
  • CT myelogram, to see the condition of the spinal cord in detail, and find out whether there are deformities in the spine

Spinal Stenosis Treatment

Treatment will depend on the type of spinal stenosis you have and the severity of your symptoms. The goals of treatment are to relieve symptoms, relieve pressure on the spinal cord, and help the patient to continue to function normally.

Some of the treatment options that doctors can give to treat spinal stenosis are:

Drugs

To relieve symptoms that arise due to spinal stenosis, doctors may give the following drugs:

  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to relieve pain and discomfort in the spine
  • Antiseizure drugs, such as gabapentin and pregabalin, to reduce pain from nerve damage
  • Tricyclic antidepressant drugs, such as amitriptyline, to reduce chronic pain
  • Opioid pain relievers, such as oxycodone, for short-term pain relief
  • Injectable corticosteroid medications, such as prednisone, to reduce inflammation and relieve pain

Physiotherapy

After the symptoms subside, physiotherapy can be done to strengthen the back and abdominal muscles, and increase the strength and flexibility of the spine. This will restore the function of movement and balance of the body that is reduced due to spinal stenosis.

Operation

Surgical procedures are performed if other treatment methods are ineffective. Spinal stenosis surgery aims to relieve pressure on the spinal cord.

Some types of surgical procedures that doctors can perform to treat spinal stenosis are:

  • Laminectomy (decompression surgery), to remove the entire part of the spinal column (lamina) that is pressing on the nerves
  • Laminotomy, to remove part of the lamina
  • Foraminotomy, to remove bone or tissue where the nerves exit the spine

Complications of Spinal Stenosis

Although rare, untreated severe spinal stenosis can lead to several complications, including:

  • Numbness in the spine
  • Balance disorders
  • Urinary incontinence
  • Paralysis

Spinal Stenosis Prevention

Given that spinal stenosis is generally caused by aging, this condition becomes difficult to completely prevent. However, there are several ways you can do to reduce your risk of developing spinal stenosis, namely:

  • Do exercise regularly.
  • Keep your weight to stay ideal.
  • Maintain good posture when sitting or standing and keep your shoulders perpendicular to your hips.
  • Check with your doctor regularly if you have a history of spinal disease.