What is the best treatment for spinal stenosis?
The best treatment for spinal stenosis depends on your symptoms. While nothing non-surgical will make it go away, physical therapy is a good place to start to help the pain.Stenosis is just a fancy way of saying narrowing, spinal stenosis is just a fancy way of saying that you have narrowing in your spine. Now while spinal stenosis isn’t strictly arthritis of the spine (called spondylosis. Confusing, I know.), arthritis of the spine is a very common cause of spinal stenosis. Bulging disks and vertebrae that don’t line up quite right (called spondylolisthesis, just to confuse you more), can also cause spinal stenosis or narrowing of the spine. I frequently see patients with spinal stenosis as an orthopedic doctor in Colorado Springs, and most do not need surgery.
What’s so bad about a narrowed spine?
Nerves are delicate structures, meaning that they don’t like to be irritated. A good way to irritate a nerve is to compress it. All of the major nerves that make your arms and legs come from the spinal cord in one way or another. Now your body is smart, and to protect your spinal cord, it encases it in bone. This is the structure of your spinal column; it supports the weight of your body and protects your nerves at the same time. The front part takes the weight, and is where the discs and most of the bone is. The middle is where the spinal cord lives. And the back has other bony and ligamentous elements that help with stability and motion.The end result is that your spinal cord and its nerves are safely protected. Now, at some point the nerves in your spinal cord need to branch off and leave the safety of the spinal column to travel down your arms and legs. The spinal column has windows for the nerves to leave called foramen. When you have spinal stenosis, these windows get smaller and the nerves can get compressed causing pain that travels down your arms or legs. You can also have central spinal stenosis causing pressure on the cord itself in the neck or back (at the lumbar level the cord is actually just nerve roots), which can cause problems of its own. This is why spinal stenosis can be a problem.
What can I do about my spinal stenosis?
Whether you have spinal stenosis from a slipped disc, arthritis, or malalignment of the vertebrae (spondylolisthesis), the end result of the nerve being compressed is the same. If the problem is from a slipped disc, almost 90% of these will go away on their own with time, light activity, and physical therapy. If the cause is arthritis or from malalignment, physical therapy and injections can help, but if all else fails surgery can be a good option in the right patient. Surgery should be the last result when everything else has failed, and you have persistent nerve related issues that are greatly interfering with the quality of your life. In my orthopedic practice in Colorado Springs, I frequently guide my patients through the risks and benefits of the treatments for spinal stenosis.
I hope I was able to answer your questions about the best treatment for spinal stenosis. If you still have any questions or want to schedule an in person or virtual consult, please feel free to contact me.
-Written by Dr. Daniel Paull