Ever have neck and low back pain with pain and/or tingling and numbness down one or both arms or legs? If you have experienced this, you could have spinal stenosis. Spinal stenosis is a broad term that refers to any decrease in the openings in the spinal canal; it can occur along the entire length of the spine. The most common areas for its occurrence are in the cervical spine (neck) and the lumbar spine (low back) regions. Spinal stenosis can occur in the central spinal canal, putting pressure on the spinal cord, causing central stenosis. Lateral stenosis, where the spinal nerves exit the central spinal canal laterally, through openings called spinal foramina, is the most common form of spinal stenosis.
Both lateral and central stenosis are commonly seen in the healthy older population, secondary to normal degenerative changes that occur during a lifetime. One of the most common of these degenerative changes is the formation of osteophytes or bone spurs in areas where excessive stress is placed on the bone of the individual vertebrae. Osteophytes are the main cause of lateral stenosis.
Another common degenerative change is the drying out of the vertebral discs, which act as cushioning between each vertebrae and help in adding height and more breathing space to the nerve roots exiting through the spinal foramina and leading to lateral stenosis. When these discs dry up, their height is lost and nerve root irritation can occur.
The disc can also become herniated centrally, taking up space around the spinal cord and leading to central stenosis. Other changes that occur with aging include the thickening of the spinal ligaments, which can encroach upon the spinal cord as in central stenosis. Other causes of either central or lateral stenosis can include cancer or tumors and spinal injuries from trauma, such as a sports injury or car accident.
Central and lateral spinal stenosis share many similar signs and symptoms, but they can usually be differentiated with a thorough evaluation and/or MRI scan of the affected area. Symptoms that are seen in both lateral and central spinal stenosis include, but are not limited to, pain in the neck or low back with pain down one or both legs or arms. When in the legs, pain is often provoked with walking or standing activity and alleviated with sitting and a forward bending posture. Other symptoms include tingling or numbness in one or both arms or legs. More severe types of symptoms include loss of bladder and bowel function.
Physical therapy can be a helpful, non invasive, method of controlling spinal stenosis, both lateral spinal stenosis and central spinal stenosis. At ProActive Physical Therapy and Sports Medicine, our skilled physical therapists can help the patient improve spinal stability and core strength in order to help minimize irritation of neural tissue and offer “tricks” to complete daily functional tasks with little to no symptoms. Please contact one of our offices to talk with a physical therapist if you have other questions regarding spinal stenosis and low back pain and learn how we can potentially help you.