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Spinal Stenosis

Pain, numbness, tingling sensation, loss of motor control are all possible symptoms of a serious condition called spinal stenosis. Spinal stenosis refers to the narrowing of the spinal canal and the reduction in size of the openings in the bony vertebral canal through which nerves can exit and branch out.

The spinal canal is the space in the vertebral column through which your spinal cord (in the upper and mid back) and nerve roots (in the lower back) pass. A variety of diverse causes including age and heredity can cause the spinal column to narrow leading to everything from back and neck pain, to difficulty balancing and walking. There are several types of spinal stenosis, with lumbar stenosis and cervical stenosis being the most frequent.

Stenosis can be treated with a variety of surgical and non-surgical methods. The course of treatment for stenosis is highly individual and depends on the patient’s overall condition, age, severity of the stenosis, and personal preferences. The doctors at the Ainsworth Institute of Pain Management are experts in diagnosing and treating spinal stenosis and can offer you treatment options not available anywhere else in New York City.

What is Stenosis?

Spinal Stenosis

As the spine ages, bony overgrowth invades the spinal canal creating stenosis

As mentioned above spinal stenosis refers to the narrowing of the cavity in your spine which contains the spinal cord and spinal nerves. The spinal cord extends from your brain all the way down the spine to the bottom, the spinal nerves branch off from the spinal cord, exit the spine and extend through he rest of the body regulating the function of organs and bodily processes.

The spinal nerves and spinal cord relay sensory information to the brain. All the sensations we feel, pleasant, unpleasant, or neutral are detected through the spinal nerves and passed up the spinal cord to the brain. In the opposite direction, this nerve highway carries messages from the brain to govern voluntary and involuntary motor functions.

With spinal stenosis, the spinal cord and spinal nerves become compressed, either within the spinal canal, or at the openings where the spinal nerves exit the spine. This results in abnormal signals getting sent to and from the brain, or not getting through at all. Patients then experience the pain, numbness or disorientation associated with spinal stenosis. It affects men and women equally and is most commonly seen in people over 50, and people who work in labor-intensive fields.

What are the Symptoms?

Stenosis can occur at any point along the spine, but cervical (neck) and lumbar (lower back) stenosis are the most prevalent. Symptoms can vary somewhat based on the level of the spine where the stenosis occurs.

Cervical stenosis
 Neck pain
 Pain, weakness or numbness in the shoulders, arms, or hands
 Impaired motor function (especially manual coordination)
 Difficulty with balance or walking

Lumbar stenosis
 Back pain

 Pain, weakness or numbness in the buttocks and legs
 Difficulty walking or standing for long periods
 Pain that can be relieved by sitting down or leaning forward
 Foot problems

What are the Causes?

Spinal stenosis can be caused by a diverse group of factors.Spinal Stenosis Causing Low Back Pain

The Aging Process
 Degeneration of the spine
 Development of bone spurs
 Thickening ligaments
 Herniated intervertebral discs
 Compression fractures, common in osteoporosis
 Spondylolisthesis
 Arthritis that can enlarge and inflame joints

Heredity
 Patient born with small spinal canal
 Deformities of the vertebrae
 Dwarfism

Other
 Injury to the back
 Tumors

What are my Treatment Options?

If you believe you are suffering from spinal stenosis you should consult a qualified physician. Typically, stenosis starts gradually and worsens over time. Stenosis will not improve or go away on its own. The doctor will most likely start by conducting a thorough physical examination and obtaining your detailed medical history. Imaging scans may also be required for a diagnosis.

shutterstock_125889608Fortunately, there are effective, non-surgical ways to treat stenosis. Conservative treatments include medication to control pain and inflammation along with physical therapy. Sometimes steroid injections are recommended.

Surgery may also be used as well, but it is not appropriate for everyone. For those who may consider a surgical intervention for stenosis, there are minimally invasive approaches that can help decompress nerves (and relieve pain) which can be done using only a small incision. A type of minimally invasive surgery for spinal stenosis is decompressive laminectomy, which removes some of the bony growths of the vertebrae to create more room and allow nerves to decompress. This type of surgery may be combined with a spinal fusion procedure to help stabilize the spine.

Interventional Pain Management Treatments
Interventional techniques can be a faster and more definitive method of pain relief for spinal stenosis. These treatments are useful in the presence of severe pain that has failed conservative medical treatment and/or medication.

Lumbar Epidural Steroid Injection – This procedure is considered a very effective treatment for spinal stenosis. It is basically the same treatment a woman will receive during childbirth.  Under fluoroscopic guidance, your physician will place a small needle into the epidural space and inject a small amount of medication to eliminate the pain.

Spinal Cord Stimulation (SCS) – When the inflammation in and around the affected nerves is too great for an epidural injection, SCS is an excellent and effective treatment option that can eliminate the pain without surgery. In SCS, an electrical pulse is delivered directly to the spine, blocking certain neuron fibers’ access to the brain and consequently the brain’s ability to sense the previously perceived pain. 

Superion – THE most cutting-edge therapy for spinal stenosis in United States.  Traditionally, the only way to correct spinal stenosis was surgery.  Unfortunately, statistics show there is about a 40% chance of the pain staying the same or even getting worse.  In the FDA-approved clinical trial, patients treated with the Superion Interspinous Spacer, 76.8% of patients reported significant improvement in back pain and 84.1% in the legs.  With Superion – the incision is the size of a button hole and patients go home a few hours later with little down time.

Important!
Although very rare, sometimes people with stenosis may experience loss of bowel or bladder control or loss of feeling or extreme weakness in one or both legs. Seek emergency medical help at once if this occurs as this is a sign of cauda equina syndrome. Cauda equina syndrome may be life threatening.

Schedule an Appointment Today

The doctors at the Ainsworth Institute of Pain Management specialize in treating spinal stenosis. Dramatic improvements in pain and quality of life are a single phone call away. Schedule an appointment today with one of our board certified pain management experts to discuss what options for treatment may best suit your needs.

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