Spinal stenosis is a narrowing of two functional elements: the spinal canal and intervertebral foramen. This restriction results in a “suffocation” of the spinal cord and/or nerve roots. The spinal canal is a structure located in the center of the spine through which the spinal cord and nerve roots pass. The spinal forametic openings, on the other hand, are located between the spinal vertebrae. Through them, the peripheral nerves leave the spinal column to spread and reach other parts of the body.


What Causes Spinal Stenosis?


Spinal stenosis is identifiable as the result of a gradual and degenerative aging process of the spine. As we age, the ligaments in the spine can thicken and calcify, compromising and affecting adjacent areas. The same applies to the bones and joints, which widen due to bone stress and which, causing the emergence of spurs and bone splinters, invade the space of the spine. On the contrary, the vertebral discs, located between the vertebrae, become dehydrated over the years. In addition, they lose strength and thickness, especially in the case of injuries or deficits such as swelling or disc disease. It is these degenerations that compromise the patient’s health.

Osteoarthritis of the spine (or spondylosis ), as a common form of spinal arthritis, is closely related to stenosis. Speaking of degenerative problems, this is likely to occur in middle-aged and elderly people. It is a chronic process produced by the daily wear and tear of the spinal joints. It is often accompanied by an overgrowth of the bones through the formation of bone spurs, which can cause spinal stenosis. There are also exceptional situations in which spinal stenosis occurs in younger women and men, mostly due to narrowing of the spinal canal present from birth or severe spinal injury.


What are the symptoms of spinal stenosis?


Common symptoms of spinal stenosis include numbnessmuscle weaknessreduced reflexescrampsgeneral pain in the arms and legs. Obviously, these general symptoms vary in intensity and location, based on the area of ​​the spine that is affected (stenotic) and how advanced the level of stenosis is. In general, pain is felt as a result of the narrowing only if this restrictive action involves compression of the spinal cord, nerves, and nerve roots. In severe cases, numbness, tingling, pain, muscle weakness can expand. As a result, other symptoms may also occur over time, such as those involving bladder and bowel function. In these cases, we speak of Cauda Equina Syndrome, and the symptoms are so severe that immediate intervention is required.

Among the most affected regions, we find the lumbar spine (lower back) and the cervical spine (neck). However, any region of the spine can be affected by this disorder. Respectively, in lumbar spinal stenosis, what happens is that the spinal nerve roots of the lower back are compressed, producing pain, tingling, weakness, or numbness, symptoms that radiate up to the buttocks and legs, especially during physical activity and movement. Cervical stenosis can cause similar symptoms, but it also affects the arms as well as potentially the legs.


Pay attention to the position!


As in the case of sciatica, if the narrow space within the spine pushes on a nerve root, pain can also be felt by virtue of the fact that it radiates along the nerve. Unlike patients with sciatica, however, spinal stenosis is relieved when sitting down due to the difference in the disc problem. In fact, in patients with stenosis, sitting or bending forward to flex the spine should relieve symptoms. This is because the flexed position is as if it “opens” the spine, widening the spaces between the vertebrae.

And this also explains the forward bent gait of subjects affected by stenosis. Indeed, because keeping the lower back bent forward relieves symptoms, patients often walk with a hunched back, leaning forward and with their head down. However, due to this adaptive posture, the lower back stiffens and develops tension in the hip flexor muscles and in the front of the hips. Standing, walking, or bending back often worsens symptoms related to stenosis, as these activities result in a narrowing of the space around the nerves.


How is spinal stenosis diagnosed?


Now, suppose you experience one or more of the symptoms I have described to you. In that case, it is essential to immediately go to professional doctors, just like Dr. Munish Lal, who will be able to diagnose stenosis and intervene through programs tailored to your needs and requirements.

The diagnosis, for example, will take place through understanding and analyzing the symptoms through interviews and tests, and then taking advantage of technologies such as CT, magnetic resonance, or myelography, useful to define the extent of the stenosis.



Treatment of Spinal Stenosis at Dr. Munish Lal Clinic


While it is the last symptom to emerge, it is the one that prompts patients to refer to doctors to treat their condition. Of course, I’m talking about pain. The initial objective is to alleviate the discomfort by acting on the inflammation: Dr. Munish Lal will intervene through instrumental therapies and massage techniques designed to soften the tense and injured areas.

In general, his methodology may consist of a series of heterogeneous treatments to manage pain. Among these are the Tecar, the laser, electrotherapy, and mobilization manuals, technical taping exhaust, the soft tissue massage, and the temporary use of a guardian for your back. Finally, Dr. Lal may recommend the use of non-steroidal anti-inflammatory drugs such as ibuprofen.

As the dynamic control of your back improves, Dr. Munish Lal will turn his attention to restoring normal pelvic and spine alignment, as well as his range of activities during the most stressful positions and postures of the body. This guiding principle also applies to areas such as the legs, which we have seen to be similarly compromised in some cases of strictures.

If symptoms of stricture persist, treatment with epidural corticosteroid injection may be considered.

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