Posts Tagged ‘Spinal Canal’
WHAT IS A PINCHED NERVE ?
People hear the term “pinched Nerve”, as in “pinched Nerve in the neck”, but often, don’t know what it really means. Most nerves don’t actually get “pinched”, as you would do with your thumb and forefinger
on a garden hose to increase pressure by direct physical contact with the house. Most nerves that are called “pinched nerves” are getting abnormal or excessive amounts of pressure, usually partial pressures. There is a gradient in the opening for the nerve called a “pressure gradient”, and when some object such as disc material, swollen tissues, etc., start to taking up more space in the hole between the bones, the “intervertebral foramen”, there can be a relative pressure increase. This can also happen if a disc starts to taking up space in the spinal canal. This situation, in which an opening through which a nerve courses, has a decrease in its size or patency, it is called “stenosis”.
Increased pressure on the nerve can cause it to function incorrectly, and depending on whether it is a motor nerve, sensory nerve, or mixed, once there is additional pressure, one can have negative outcomes. A motor nerve that has too much pressure on it can result in decreased strength of an extremity for example, or, if there is sensory function to the nerve, one might feel numbness, or a decreased ability to feel certain stimuli.
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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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Insider Secrets to Find the Cause of Your Back Pain Now
During my 17 years practicing medicine, patients and friends constantly ask me:
“What is the most likely cause of my Back pain?”
I’ve written this simple guide for people who have the same question in mind.
The commonest type of Back pain is caused by tears or strains to ligaments, tendons or muscles around the lower spinal cord. The underlying factors are straining, poor posture, incorrect lifting and inactivity. The pain usually appears 36-48 hours after the strain or can be gradual in onset. The symptoms can be mild to moderate depending on the level of injury.
Herniation of a vertebral disc may be associated with back pain and also sciatica…shooting pain down the back of one leg. It is most often seen in people in their 30′s and 40′s but can also occur in the elderly. The condition is caused by underlying disc degeneration. This can lead to a gradual rupturing of the disc and Herniation of the disc contents. This process can be exacerbated by physical straining or exercise. The sciatica occurs when the disc contents press on the neighboring spinal nerve. The pain, which can be very severe, may be associated with numbness or tingling in the area supplied by that nerve (dermatome).
Facet Joint Arthropathy can result from arthritic changes, degeneration or trauma to the facet joints of the vertebral bodies of the spine. These joints are normally covered with cartilage and lined by synovial membranes. Arthritis leads to wear and tear of the cartilage and inflammation of the membranes. This leads to grating movements between the two facet joints. This type of back pain is worsened by torsion or elongation of the spine. The pain is normally well localized and may spread to the buttocks.
Narrowing of the spinal canal (Spinal Stenosis) is more commonly seen in the elderly. It is secondary to vertebral degeneration. It may also occur with infection, trauma, tumors and arthritis of the spine and with bony spurs and disk herniation. It can progress to severe spinal cord injury. It is associated with back pain as well as pain, numbness and weakness of the buttocks.
Radiculopathy (‘a pinched nerve’) is associated with back pain and pain, numbness, weakness and tingling of the legs. It occurs when inflammation of a spinal nerve is caused by pressure or friction. The underlying factors can be tumors, bony spurs, disc herniation, and fractures of the vertebrae. The presence of muscle weakness in the legs as well as pain in the back… indicates severe symptoms. In such cases you should seek a doctor’s advice immediately.
Tumors of the spine, whether they originate in the spine or spread from distant organs, can cause terrible back pain through pressure on the nerves and spine. Chronic persistent pain despite treatment is suggestive although not diagnostic of a spinal tumor. Be suspicious when such pain is associated with generalized signs of cancer such as weight loss, loss of appetite and tiredness.
Infection of the spinal cord or surrounding tissues causes pressure on the spine and can result in severe back pain and loss of function of the affected spinal nerves. Examples include spinal meningitis and osteomyelitis.
Pathology of the vertebrae of the spine can cause pressure on the spinal nerves, inflammatory conditions and degeneration. Examples include osteoarthritis, osteoporosis and ankylosing spondylitis. Ankylosing spondylitis is characterized by pain in the back and stiffness. This stiffness is more pronounced in the morning as is not helped by rest. There may also be pain in the shoulders, neck and mid-spine. Osteoporosis ( low bone mass) leads to fractures. Fractures cause sudden severe back pain localized to the area of the fracture. Osteoarthritis, the wear and tear of joints with age, leads to chronic back pain which tends to be poorly localized. It is normally associated with stiffness and pain which is not eased by rest.
anonymous
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Understanding Spinal Stenosis
Spinal stenosis is a narrowing of the spinal canal resulting in a lack of space to accommodate the nerves.
The spinal canal contains the nerves that connect to the skin and Muscles of the legs. A normal size canal has sufficient space to hold these nerves. But, as a person ages, the canal is subject to narrowing. The narrowing may not always result in problems. But if the narrowing causes pinching of the spinal nerves, problems will develop.
Spinal stenosis isn’t always caused by degeneration due to age. It can also be due to tumors, herniated discs, and injuries resulting from accidents. Spinal stenosis can even be present at birth but this is rare.
The symptoms of spinal stenosis vary depending upon the location of the compressed Nerve. If the nerves in your neck or shoulder are pinched, you will experience pain in this area.
If the pressure is on the nerves that control your balance, you will tend to be clumsy or fall easily.
When the stenosis results from a herniated disc, the pain will begin in your hip or buttocks and travel down the back of your leg. In this case, the pain is confined to one side of your body but increases when you sit.
If the pinched nerves are in your lower lumbar region, you can have a condition known as false claudication. People with this problem have pain and cramping in their legs make it difficult to stand straight in one position for long periods of time. Sitting down relieves the discomfort. Walking is easier when bending forward which is why many people with spinal stenosis prefer to shop at stores that have shopping carts. Leaning forward on the cart makes walking much easier. False claudication also makes downhill walking difficult.
There is another form of claudication called vascular claudication, which is a blockage in the arteries in the legs. This also causes pain and cramping but unlike false claudication, it gets worse when walking up hill and gets better when you stand still.
Other symptoms of spinal stenosis are numbness in the arms, hands, feet, or legs and loss of bladder or bowel control. People who experience the numbness need to be careful, as it is possible to injure the body part and not be aware of it due to reduced sensitivity.
Anyone have problems with bowel or bladder control need to consult their physician immediately.
Doctors use radiographs and MRI’s (magnetic resonance imaging) to diagnose spinal stenosis. The radiographs show whether arthritis is present and if there is any slippage of the vertebrae. The MRI scan is needed to detect whether or not there is any pinching of the nerves. There are also special tests available for people who cannot have an MRI.
There are two basic types of treatment for spinal stenosis – surgical and nonsurgical.
Nonsurgical treatments involve physical therapy, anti-inflammatory medication, and epidural steroid injections.
People need to be cautious about the anti-inflammatory medications as many of these have serious side effects. They should be thoroughly discussed with the doctor prior to taking the medications.
The steroid medication is injected directly into the nerve roots within the spinal canal. There are less side effects with this treatment and sometimes it will allow patients to avoid surgery.
The non-surgical treatments are only useful for providing relief from symptoms. They do not decrease the narrowing of the canal.
There are two types of surgical treatments. One, called decompression, consists of removing the bone and soft tissues that are pinching the nerve.
The other involves a spinal fusion during which two or more vertebrae are permanently fused together.
Surgery is usually viewed as a last resort to be attempted when all other treatments fail. However, if there is loss of bladder or bowel control, surgery will be performed immediately.
Brenda Williams
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Understanding Spinal Stenosis
Spinal stenosis is a narrowing of the spinal canal resulting in a lack of space to accommodate the nerves.
The spinal canal contains the nerves that connect to the skin and muscles of the legs. A normal size canal has sufficient space to hold these nerves. But, as a person ages, the canal is subject to narrowing. The narrowing may not always result in problems. But if the narrowing causes pinching of the spinal nerves, problems will develop.
Spinal stenosis isn’t always caused by degeneration due to age. It can also be due to tumors, herniated discs, and injuries resulting from accidents. Spinal stenosis can even be present at birth but this is rare.
The symptoms of spinal stenosis vary depending upon the location of the compressed nerve. If the nerves in your neck or shoulder are pinched, you will experience pain in this area.
If the pressure is on the nerves that control your balance, you will tend to be clumsy or fall easily.
When the stenosis results from a herniated disc, the pain will begin in your hip or buttocks and travel down the back of your leg. In this case, the pain is confined to one side of your body but increases when you sit.
If the pinched nerves are in your lower lumbar region, you can have a condition known as false claudication. People with this problem have pain and cramping in their legs make it difficult to stand straight in one position for long periods of time. Sitting down relieves the discomfort. Walking is easier when bending forward which is why many people with spinal stenosis prefer to shop at stores that have shopping carts. Leaning forward on the cart makes walking much easier. False claudication also makes downhill walking difficult.
There is another form of claudication called vascular claudication, which is a blockage in the arteries in the legs. This also causes pain and cramping but unlike false claudication, it gets worse when walking up hill and gets better when you stand still.
Other symptoms of spinal stenosis are numbness in the arms, hands, feet, or legs and loss of bladder or bowel control. People who experience the numbness need to be careful, as it is possible to injure the body part and not be aware of it due to reduced sensitivity.
Anyone have problems with bowel or bladder control need to consult their physician immediately.
Doctors use radiographs and MRI’s (magnetic resonance imaging) to diagnose spinal stenosis. The radiographs show whether arthritis is present and if there is any slippage of the vertebrae. The MRI scan is needed to detect whether or not there is any pinching of the nerves. There are also special tests available for people who cannot have an MRI.
There are two basic types of treatment for spinal stenosis – surgical and nonsurgical.
Nonsurgical treatments involve physical therapy, anti-inflammatory medication, and epidural steroid injections.
People need to be cautious about the anti-inflammatory medications as many of these have serious side effects. They should be thoroughly discussed with the doctor prior to taking the medications.
The steroid medication is injected directly into the nerve roots within the spinal canal. There are less side effects with this treatment and sometimes it will allow patients to avoid surgery.
The non-surgical treatments are only useful for providing relief from symptoms. They do not decrease the narrowing of the canal.
There are two types of surgical treatments. One, called decompression, consists of removing the bone and soft tissues that are pinching the nerve.
The other involves a spinal fusion during which two or more vertebrae are permanently fused together.
Surgery is usually viewed as a last resort to be attempted when all other treatments fail. However, if there is loss of bladder or bowel control, surgery will be performed immediately.
Brenda Williams
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