What Causes Spinal Stenosis?
Understanding the potential causes of various medical conditions can help protect your health for years to come. This is certainly true of back pain, which is one of the most prominent medical problems today. It affects an estimated eight out of 10 Americans at some point in life and can stem from conditions like spinal stenosis.
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Spinal stenosis is a common source of chronic back pain. It develops when the spinal canal narrows, often due to age-related changes in the spine. Working to prevent spinal stenosis can help preserve the condition of your spine so that you can remain mobile in the later stages of life.
In this article, we’ll discuss spinal stenosis and its most common causes.
How Do You Develop Spinal Stenosis?
You develop spinal stenosis either from age-related wear and tear on the spine or genetic factors. The former is known as degenerative spinal stenosis, and the latter is known as congenital spinal stenosis.
The spine undergoes significant strain over a lifetime. This accumulated wear and tear, combined with the body’s natural aging process, can lead to bone spurs, thickened spinal ligaments, herniated discs, and various other spinal injuries. All of these factors reduce the amount of space in the spinal canal, leading to spinal stenosis.
Virtually everyone develops degenerative spinal stenosis later in life. However, some people are more likely to develop symptoms of spinal stenosis that require treatment. Risk factors for spinal stenosis include:
- Previous spinal trauma
- Repeated strain on the spine, which is commonly seen in athletes
- Spinal tumors
- Other underlying spinal problems
What Is the Main Cause of Spinal Stenosis?
The main cause of spinal stenosis is age-related spinal changes. More specifically, osteoarthritis is the primary cause of this spinal condition. Osteoarthritis develops gradually as people age, causing joint inflammation from the breakdown of protective cartilage.
Osteoarthritis is also known as wear and tear arthritis. It can lead to spinal stenosis when it affects the joints located between the vertebrae of the spine. As the cartilage that cushions these joints degenerates, bone spurs can develop and narrow the spinal canal.
The ligaments in the spinal canal can also thicken as the aging process advances, potentially leading to spinal stenosis.
Can Stress Cause Spinal Stenosis?
Both physical and psychological stress can cause spinal stenosis. Physical stress gradually contributes to spinal degeneration, which can lead to spinal stenosis. However, people often overlook the fact that psychological stress can also trigger spinal stenosis, for a few different reasons.
For one, emotional stress tends to make people tense their muscles. This muscle tension can throw off the alignment of the spine, ultimately placing additional impact on the spine with day-to-day motions.
Additionally, according to a 2010 study published in the International Association for the Study of Pain, chronic stress causes spinal neuroinflammation. Spinal neuroinflammation, which is an inflammatory response in the spinal cord, can contribute to and worsen spinal stenosis symptoms.
What Are the Warning Signs of Spinal Stenosis?
The warning signs of spinal stenosis are back pain that improves when you sit or bend forward, neurological symptoms that radiate into the legs and/or feet, an abnormal gait, and difficulty walking and/or standing. Some physicians ask if patients experience symptom relief when they lean forward on a shopping cart, which is common among people with spinal stenosis.
If you experience one or multiple of the signs listed above, start with at-home care methods. If the symptoms don’t resolve within a few weeks, schedule an appointment with a spinal specialist for an evaluation.
Is Spinal Stenosis Permanent?
Yes, spinal stenosis is permanent. The only way to open the spinal canal back up is with surgical spinal decompression. However, many patients can manage and improve their symptoms with non-surgical spinal stenosis treatment.
Is Spinal Stenosis a Serious Problem?
Yes, spinal stenosis is a serious problem. Although it’s extremely common, it can cause permanent damage if it’s left untreated. Since it involves the spinal nerves and spinal cord, permanent nerve injury (including paralysis) is a legitimate risk of this condition.
Spinal stenosis can also gradually lead to disability if it’s not managed properly. The condition naturally progresses with time, potentially making it more difficult for you to work, exercise, socialize, and enjoy all of your favorite activities.
Though spinal stenosis is undoubtedly a medical condition that you need to take seriously, it can be successfully managed with professional medical treatment.
What Are The Symptoms of Spinal Stenosis?
The symptoms of spinal stenosis include:
- Persistent lower back pain
- Neurological symptoms (numbness, weakness, and tingling) stemming from the lower back to the buttocks, thighs, and legs
- Sciatica (burning pain that extends from the lower back to the buttocks and backs of the legs)
- Foot drop (weakness in the foot that causes it to slap on the group while walking)
Symptoms of severe spinal stenosis can include difficulty with bladder and bowel control, as well as sexual dysfunction. If this occurs, patients should seek out emergency medical care, as it may be an indication of cauda equina syndrome.
A significant number of spinal stenosis cases don’t cause noticeable symptoms. In these cases, the narrowing of the spinal canal doesn’t lead to nerve impingement. However, as the case progresses, patients are likely to eventually experience symptoms.
How Common is Spinal Stenosis?
Spinal stenosis is fairly common. Degenerative spinal stenosis is significantly more common than congenital spinal stenosis.
In one study, the prevalence of congenital lumbar spinal stenosis among U.S. patients was found to be 4.71% for relative stenosis and 2.62% for absolute stenosis. With relative stenosis, the anteroposterior (AP) dimension of the spinal canal shrinks to 12mm. With absolute stenosis, the AP dimension of the spinal canal shrinks to 10mm or less.
In the same study, the prevalence of relative acquired (degenerative) lumbar spinal stenosis among patients aged 60 to 69 was 47.2%. The prevalence of absolute degenerative lumbar stenosis in this age group was 19.4%.
What is The Surgery For Spinal Stenosis?
The surgery for spinal stenosis is generally a procedure known as decompression laminectomy. Spinal fusion may also be done with this procedure to stabilize the spinal structures and prevent future injury.
A laminectomy is a form of spinal decompression surgery. In this procedure, some or all of the lamina, which comprises the back of the spinal canal, is removed to alleviate nerve compression.
Spinal fusion has conventionally been done after spinal decompression to fuse the affected vertebrae into one bone. But, given that it permanently limits spinal mobility and doesn’t always alleviate the patient’s back pain, alternative treatment methods have recently been developed.
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The TOPS System is one spinal fusion alternative that creates a controlled range of spinal motion after laminectomy. Designed to be used for lumbar spinal stenosis and spondylolisthesis, this non-fusion implant can resolve pain and neurological symptoms without compromising spinal mobility. Patients also have far fewer restrictions on them during the TOPS recovery process when compared to spinal fusion.
If you’re suffering from symptoms of spinal stenosis, contact a spine specialist in your area to learn about your treatment options.