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Is Spinal Stenosis the Source of Your Sciatica Pain?
What is Spinal Stenosis?
Spinal stenosis is a medical condition where the spinal canal becomes narrow. This narrowing can put additional pressure and compression on the spinal cord and can cause a pinching of the nerve roots. If the narrowing is in the lower part of spinal cord it is referred to as lumbar spinal stenosis and if the narrowing is in the upper part of the spinal cord then it is referred to as cervical spinal stenosis. While stenosis can also occur in the thoracic or upper back region, the lumbar and cervical areas are the most common.
Who Can Get Spinal Stenosis?
Although some people are born with spinal stenosis, the condition is usually seen in people over the age of 50 who already have some disc degeneration. Often, spinal stenosis results from the wearing down on the spine from normal activities. As we get older, our spinal ligaments can calcify, bone spurs may form, and we can get herniated or ruptured discs. All these conditions can lead to a narrowing of the spinal canal which can compress and pinch the spinal nerves.
Spinal Stenosis Symptoms
Symptoms of spinal stenosis can include back pain radiating to the legs, numbness or Pain in the buttocks that worsen when walking or exercising, leg weakness, decreased physical endurance, loss of balance, and leg and neck pain.
Treating Spinal Stenosis
In general doctors tend to take a conservative approach when initially treating spinal stenosis. Drug therapy such as pain relievers and anti-inflammatory medications to reduce swelling are usually prescribed first, along with bed rest and reduced physical activity. Steroid injections can also be use to help reduce swelling although the pain relief is normally temporary. Traction and spinal decompression may be prescribed, along with physical therapy which can be used to help increase flexibility as well as build endurance.
If the pain is acute, then surgery may be needed in order to widen the spinal canal and to correct the conditions that are contributing to the nerve compression. Some of the surgical procedures used to treat spinal stenosis are:
Decompressive laminectomy. This is used for treating lumbar spinal stenosis and involves removing the top of the vertebra to create more space for the nerves.
Laminotomy. This is a partial removal of the lamina which can be done to widen the spinal canal and relieve compression on the nerve roots.
Foraminotomy. Removal of bone, scar tissue, or other obstructions that are compressing the nerve root exiting the spinal canal.
Due to the risks involved, many doctors will resort to surgical treatments only after non-surgical treatments have been tried first.
This article is not meant to replace the sound advice of a personal physician. Patients should discuss with their doctor all their treatment options before taking any medical course of action.
Dan Raymond
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Stenosis – Back Pain Test
Stenosis Back Pain originates in the spinal canal itself. Stenosis occurs when the spinal canal narrows, and compresses the nerves inside it. This compression of the nerves can lead to stenosis Back pain, numbness in the legs, and the loss of bladder or bowel control. If left untreated, stenosis Back Pain can eventually become paralysis.
It is estimated that approximately 400,000 Americans currently have spinal stenosis back pain. That number is expected to increase as Baby Boomers age.
Defining Stenosis Back Pain
You probably know that the spinal column protects your spinal cord, a bundle of nerves, from being injured. In spinal stenosis, the spine narrows in one or more of three places: space at the center of the spine; canals where nerves branch outward from the spine itself; a space between the spine’s bones (vertebrae).
Stenosis back pain occurs when the narrowing puts pressure on the nerves inside the spinal column. Although this can occur in younger people, it is most often a complaint of those over 50 years of age.
Causes of Stenosis Back Pain
Spinal stenosis back pain can be caused by a number of factors.
1. Age is a primary factor. As we age, bands of supportive tissue in the spine may harden and thicken. Our bones and joints may enlarge as they age. We may get bone spurs on the spine – places where bone surfaces bulge outward.
2. Arthritis is another cause of spinal stenosis and accompanying stenosis back pain. Either osteoarthritis or rheumatoid arthritis may be to blame. Osteoarthritis is the more common of the two. This type of arthritis usually is seen in middle-aged and older people, and does not go away. Osteoarthritis can cause the bone spurs described above. Rheumatoid arthritis is usually seen in younger people, and is not usually a cause of spinal stenosis back pain.
3. Inherited factors may also lead to stenosis and stenosis back pain. Some genetic conditions, such as a small spinal canal or curved spine, can cause spinal stenosis.
4. Other causes for your stenosis back pain could include calcium deposits, fluoride accumulation, or injuries.
Symptoms of Stenosis Back Pain
Stenosis back pain usually occurs in the neck or back. In addition to the stenosis back pain, you may feel pain down one leg, or numbness, weakness, cramping, and pain in legs or arms as the nerves are compressed.
Stenosis Back Pain Test Problem
The problem with tests for spinal stenosis is that the conditions shares symptoms with so many other disease. The result has too often been costly misdiagnoses and unnecessary back surgery, according to Andrew Haig, M.D., associate professor in the Department of Physical Medicine and Rehabilitation at the University of Michigan Medical School.
The following 3 tests are used to diagnose the cause of stenosis back pain.
1. Magnetic resonance imaging (MRI) -radio waves to picture the spine
2. Computerized axial tomography (CAT) – X-ray series to picture the spine
3. Electromyogram (EMG)- a test that not only gives a picture of nerves, but also tests nerve function, showing if there is actual nerve damage
Best Stenosis Back Pain Test
Of the three, the oldest, Electromyogram (EMG) has been found to be the best. This test has been around as long as, or longer than the Baby Boomers themselves, but a study published in the January 2006 issue of “Spine” shows that it is by far the best of the three tests.
That study, done by the University of Michigan Health System, shows that the EMG test accurately determines the cause of stenosis back pain. As a result, low back pain is less likely to be misdiagnosed, as are other common neuromuscular conditions with similar symptoms. Back surgery undertaken to cure misdiagnosed stenosis back pain can be avoided with this stenosis back pain test.
Tests done in the U of M study by Dr. Andrew Haig and his colleagues showed a substantial difference between those who have spinal stenosis and those with other types of back pain. It showed that use of the EMG allows experts to clearly distinguish between spinal stenosis and low back pain.
“Most doctors think of EMG as a simple test and incorrectly believe that it is sensitive for nerve damage, but cannot differentiate spinal stenosis form neuromuscular disease,” explains Haig. “But as this study shows, that’s not the case. In fact, EMG is an excellent test for spinal stenosis and other neuromuscular disorders using strict evidence-based criteria.” (Spine, Vol. 30, No. 23)
Anna Hart
http://www.articlesbase.com/medicine-articles/stenosis-back-pain-test-122606.html
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