Spinal canal stenosis is a condition where the spinal canal narrows putting excess pressure on the spinal cord and nerves. Its usually affects men and women over the age of 50, however younger people may also be affected by spinal stenosis if they are born with abnormally small spinal canals.
Our spine consists of 24 individual vertebrae and it is these bones that create a spinal canal that protects our spinal cord.
The canal is an important structure to allow messages to flow unimpeded from our brain to all our cells in our body, however if the canal changes in size or shape may have an impact on our spinal health.
Usually there is adequate space in our spinal canal for our nerve to travel freely between our vertebrae, however if there is any excessive bone growth (spinal degeneration), disc bulge or soft tissues (thicken spinal ligaments, cysts, tumours) growing inside our canal it may start to put pressure on the spinal cord/ nerves causing irritation, therefore low back /neck pain and other symptoms like leg /arm pain become evident.
There are two types of Spinal Canal stenosis:
- Central Canal Stenosis
Narrowing of our spinal canal. Patients with central canal stenosis affecting the low back will often experience referred pain into both legs, while central canal stenosis affecting the neck will often refer pain in both arms.
2. Lateral Canal Stenosis
Narrowing of the intervertebral foramen (IVF). This is a foramen where the nerve roots exit from our spinal cord to supply all our muscles and organs. We have two IVFs in each vertebral joint complex, therefore if only one IVF is compromised people will experience pain down the associated leg or arm.
What symptoms may I experience?
Spinal stenosis can feel very similar to a disc bulge/herniation in the neck or low back. However, spinal canal stenosis is considered a chronic and slow progressing condition while a disc bulge/herniation is usually considered an acute injury.
Spinal stenosis in the low back is most common and can produce buttock pain and “pins and needles” in the upper thigh or leg. Patients also report symptoms of heaviness, weakness and pain when walking or prolonged periods of standing due to pressure and stretching of the irritated nerves (neurogenic claudication).
Often when the patient bends forward they will get relief as this movement enlarges the spinal canal and reduces pressure on the irritated nerves.
Spinal stenosis in the neck is less common. Patients may experience similar symptoms to stenosis of the low back, however they will feel the symptoms in their arms and/or hands. Bringing your chin down toward your chest may reduce the symptoms due to increasing the size of the spinal canal.
How do you diagnose Spinal Canal Stenosis?
A thorough Chiropractic assessment and history is required to diagnosis which spinal canal stenosis the patient is experiencing. Whether the patient describes relief upon bend forward or rest will help us differentiate between other conditions.
Diagnostic modalities like CT scans or MRI will help diagnose spinal stenosis.
X-rays may be used, however this diagnostic modality will only reveal if the patient is suffering from Lateral Canal Stenosis.
How do we treat Spinal Canal Stenosis.
Biomechanical joint dysfunction (subluxation) of the low back and neck may contribute these symptoms of spinal canal stenosis. Even though Chiropractic cannot reverse any space occupying structure like spinal degeneration, cyst or tumours, we can restore normal joint function to your spinal via adjustments and mobilization therapy which in turn may provide you with relief.
We will also provide you with a specific strengthening/stretching program to help manage your symptoms to achieve the best possible outcome.
- Exercise / Stretch
Exercise and stretching programs may help to maintain good spinal motion. Strengthening your core muscles and the low back will provide more stability. Lower stress activities like swimming or using an exercise bike can assist your spinal health.
*People suffering from osteoporosis should not perform swimming as an exercise.
Anti-inflammatory drugs like Nurofen or Voltaren can often reduce the inflammation around the affect area in the spine, however these drug do not treat the core issue.
- Epidural Steroid Injections
These injections are administered directly to the area affected to help reduce inflammation. Again, this type of therapy may be temporary and will not address the cause of the underlying problem, however it may assist people to start a strengthening exercise program.
If symptoms are severe, surgery is another option where the operation involves decompressing (stopping irritation) the nerves. At times spinal fusion may be another option to stop movement in the affected area.
What to do next?
It is important that you obtain an accurate diagnosis before commencing any form of therapy.
A thorough examination by a Chiropractor and another health professional will help investigate the cause of symptoms through neurological testing, orthopaedic testing, muscle strength examination, physical examination and/or other diagnostic modalities.
We will then provide you with the best course of action whether it is Chiropractic care, exercises or referral to your local medical practitioner.
If you have any questions please do not hesitate to contact us on 9792 1945.