What Is Arthritis/Spinal Stenosis?
Spinal stenosis is the narrowing of the space for the spinal cord or nerve branches. More specifically, as the spine degenerates over time, it can lead to the formation of bone spurs. As the bone spurs form, the size of the spinal canal (boney tunnel transmitting to the spinal nerves) becomes smaller. The bone spurs press on the spinal cord or the nerve roots, often causing pain. This degenerative condition is most common in the upper spine (neck) region or in the lower spine (lumbar) region. It is also associated with spondlylolisthesis (vertebra that slips forward and is not in line with the others) and scoliosis (crooked spine) More than 1.2 million Americans suffer back pain stemming from spinal stenosis, with men and women being affected equally. Women, however, are more likely to have symptoms that require treatment. Arthritis is the most common cause of spinal stenosis. While spinal stenosis can affect younger patients, it is most common in those 60 and older.
What Are the Symptoms of Spinal Arthritis & Spinal Stenosis?
There may be no symptoms with spinal stenosis or the symptoms can come and go. Inflamed nerves lead to pain. Other symptoms include:
- Legs, back or buttocks that are sore, numb, tingling or weak
- Pain that decreases when sitting or bending forward (creating room in the spinal canal)
- Pain that worsens with prolonged walking or standing
- Cramping in legs
- Pain that shoots into one or both legs, similar to sciatica
- Loss of control of arms and legs (called spasticity) that can lead to trouble walking or the inability to hold objects
- Loss of use of legs
- Loss of bowel or bladder
If you experience major weakness or can't control your bladder or bowels, seek help from a board-certified spine physician immediately as these symptoms can signal a more serious problem.
What Are the Causes of Spinal Arthritis/Spinal Stenosis?
Primarily, spinal stenosis and the accompanying arthritis are the result of the normal aging process. The gelatinous discs that cushion the vertebrae in the spine begin to dry out as we age, resulting in shortened disc height. This puts pressure on the facet joints. As they feel more pressure, they too deteriorate, leading to arthritis. The arthritis can cause the ligaments around the joints to thicken and enlarge, decreasing space in the spinal canal for nerves to pass through. The cartilage that protects joints wears away as well. Too much wear leads to bone-on-bone rubbing. To compensate for the missing cartilage, the body may grow bone in the facet joints. The bone overgrowth is called spurs, and their formation further contributes to the narrowing of space in the spinal canal for nerves to pass through. Once the space within the spinal canal becomes too cramped, pain can ensue.
What Are the Treatments for Spinal Arthritis/Spinal Stenosis?
Physicians at Midwest Orthopaedics at Rush first use conservative, nonsurgical treatments for spinal stenosis.
Non-surgical treatments do not correct spinal canal narrowing. Instead, the treatment options for spinal arthritis and spinal stenosis are aimed at controlling pain and improving quality of life for patients. Some treatment options include:
- Nonsteroidal anti-inflammatory drugs to reduce swelling
- Physical therapy to increase flexibility
- Spinal steroidal injections or "blocks"
Recent studies by the National Institute of Health show that surgical intervention leads to improved clinical outcomes when compared to non-surgical treatments for lumbar spinal stenosis herniated lumbar discs.
Dr. Singh or Dr. Phillips may recommend surgery. The goal of the surgery is to open up the spinal canal to give nerves adequate space. While surgery to open the spinal canal relieves leg pain, it is less reliable in alleviating back pain. There are two primary kinds of spinal stenosis surgery: lumbar laminectomy and lumbar fusion.