The famous author, Jules Renard once said, “It’s not how old you are. It’s how you are old.” It is not one hundred percent certain if he was referring to our personalities or to our health, but when it comes to spine health his words seem very fitting.
Aging is a natural part of life, and knowing what to expect from our bodies as we age is key to maintaining health and wellness. If you are over 50 years of age and have started experiencing some discomfort in your back and legs you might be dealing with spinal stenosis and this article might be for you.
What Is Spinal Stenosis?
There are 33 interlocking bones (vertebrae) that make up your spine. Certain bones, such as the thoracic, lumbar and sacral bones, have an opening that is known as a foramen. The openings of these bones all line up to create a protective channel around your spinal cord. This channel is known as the spinal canal.
The word “stenosis” means “narrowing” in Greek. Basically, spinal stenosis is a narrowing of the spinal canal. Stenosis can occur anywhere on your spine, but it is most often found in the neck and lower back and it can cause pain by putting pressure on your spinal nerves.
3 Types Of Spinal Stenosis
Spinal stenosis can affect three different parts of the spine. First, there's the central canal where the spinal cord lives. This canal can become narrow from front to back, which can squeeze the nerves and reduce blood flow to the spinal cord in the neck area (cervical) or the bundle of nerves at the lower end of the spinal cord (cauda equina) in the lower back (lumbar).
Secondly, there are the neural foramen, which are little openings where the nerve roots come out of the spinal cord. These can get squeezed if a disc bulges out, if the joints in the spine get bigger, or if one vertebra slips over another.
Lastly, there's something called the lateral recess, which is only found in the lower back. It's the area along the side of the spine where a nerve root goes before it exits through one of those little neural foramen openings. This area can also get compressed if the joints in the spine get bigger.
Depending on which part of the spine is affected, the symptoms can vary. This means that different treatments might be needed for each type of compression. So, if you're experiencing symptoms related to spinal stenosis, it's important to get checked out by a healthcare professional who can recommend the right treatment for you.
Is Spinal Stenosis Serious?
Spinal stenosis is a natural part of aging and generally occurs in people aged 50 years and older. Spinal stenosis is often due to general wear and tear to the cartilage between our bones and it is actually relatively common. Some people have significant amounts of pain with spinal stenosis, while others may have no symptoms at all.
If a spinal nerve or the spinal cord stays compressed for a longer period of time some serious problems can occur. When this compression of the spinal cord lasts for a long time it can lead to permanent numbness or paralysis.
Spinal stenosis can also end up affecting your balance, how you walk, your bowel and bladder functions, as well as your grip strength.
The good news is that spinal stenosis is not generally a progressive condition. Those who suffer from this condition find that the pain tends to come and go, but it does not get progressively worse over time.
What Does Spinal Stenosis Feel Like?
Spinal stenosis often brings feelings of pain, as well as feelings of numbness or weakness in the lower parts of the body like the lower back, hips, glutes, groin and legs.
People with spinal stenosis often find that their symptoms get worse when they are standing or walking, and that they tend to feel better when they are sitting or lying down.
Causes of Spinal Stenosis
The most common cause of spinal stenosis is osteoarthritis. Osteoarthritis is one of the most common forms of arthritis that happens when the cartilage that cushions our bones gets worn down over time. There are two main ways that osteoarthritis can cause spinal stenosis:
Bone spurs start to form on the vertebrae, putting pressure on the spinal nerves.
As the vertebral cartilage gets worn down the nerves start to get pinched.
Other conditions that can cause spinal stenosis include:
Bulging/herniated discs
Previous surgeries
Can Spinal Stenosis Be Cured?
Our bodies are amazing machines and while we do actually grow new bone in response to the wear and tear of time on our spines, most often this new growth occurs in the form of bone spurs, which grow into the spinal canal.
Research continues to take place into treatments such as stem cell treatments for spinal disc regeneration, but at this point in time there is no known cure for spinal stenosis. There are, however, many different types of treatments that can help to strengthen the back, restore mobility, reduce pain, and manage the condition.
Best Treatments For Spinal Stenosis
1. Cortisone Injections
Epidural steroid injections are a common treatment for spinal stenosis. Corticosteroids are powerful anti-inflammatory medications that are injected directly into the epidural space to reduce inflammation of the nerves that are causing the back and leg pain.
Doctors recommend getting these injections between 3 and 6 times per year but for chronic conditions some individuals may last up to 6 months before getting a follow up injection.
2. TENS Units
A common question is does TENS help spinal stenosis? TENS units may be helpful for some people as they can be used in a home setting and have been reported to help with some pain relief. It is important to keep in mind that research does not support the use of TENS units for low back pain.
Research from the American Academy of Neurology found that “TENS units are not effective at treating chronic low back pain”. TENS units are also not part of the international guidelines for the management of lower back pain.
3. Exercise
Exercise is a guideline based treatment for managing lower back pain. Exercise is an excellent way to support spine health. Exercise can have many benefits for reducing low back pain:
Maintain or increase spinal flexibility
Improves range of motion
Strengthens back muscles
Improves and increases circulation leading to increased delivery of oxygen and nutrients to the tissues.
Strengthens your core muscles which help to support the spine
Reduces inflammation in muscles and tissues
Some of the best exercises for low back problems like spinal stenosis are low impact activities such as swimming, biking, or walking.
Before starting a new exercise program you should consult with your healthcare provider to make sure that there are no concerns around the type of exercise program you are considering.
4. Physical Therapy
Physical therapy is another treatment that comes highly recommended by healthcare professionals around the world. Physical therapy can help with the following for spinal stenosis:
Reduce pain in soft tissues (muscles, ligaments, tendons)
Strengthens the muscles, helping to support the spine appropriately
Improve function and range of motion
Some techniques that physical therapists use when treating spinal stenosis are:
Education around the condition
Exercises to help strengthen your muscles and support your spine
Stretching to help reduce joint stress
Massage therapy to help relax muscles and improve range of motion
Heat therapy to improve circulation to the muscles and soft tissues
Ice therapy to help reduce inflammation and relieve pain
Home exercises to help continue the work between sessions.
5. Sleep
Sleep is one of the most underutilized tools for the management of lower back pain. When our bodies don’t get the right amount of quality sleep, research has shown that it can actually make your body more sensitive to pain.
A study conducted in 2020 by Na-Kayoung Lee and colleagues found that poor sleep quality is common among people with lumbar spine stenosis. After studying around 150 people with spinal stenosis they concluded that “Poor sleep quality has an adverse effect on functional disability and health-related quality of life in symptomatic LSS patients.”
Insufficient sleep can also trigger inflammation and suppress the release of the natural healing growth hormone that helps to heal our bodies while we sleep.
Practicing good sleep hygiene can have significant benefits for spinal stenosis sufferers. Some key hygiene tips include:
Avoiding screens with blue light at least an hour or two before sleep.
Sleeping in a cool, dark room.
Sticking to a regular sleep routine that helps your body know when it is time to start getting sleepy.
Avoiding alcohol before bed.
Avoiding caffeine in the afternoons and evenings.
Engaging in regular exercise during the day.
Conclusions
While spinal stenosis may be common and be assumed to be a natural part of aging, it is encouraging to know that there are things that we can do to slow down the wear and tear on our spines, strengthen the muscles supporting our spine, and find ways to help rest and heal our bodies.
In yoga there is a saying that you are only as young as your spine. Our spines do so much for our bodies. By engaging in healthy habits while we are younger we can reduce some of the wear and tear that our spines will experience and hopefully be able to stay mobile and active well into our later years.
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