Spinal stenosis is a painful condition resulting from the compression of spinal cord caused by bone degeneration and the loss of dura space surrounding the spinal cord. The condition tends to worsen with age.
Cervical spinal stenosis occurs in the neck area, from C1 to C5, and affects the head, neck, shoulders and upper back. Patients with severe cases may encounter paralysis. It can often be difficult for patients to understand the cause of this type of pain. It can be triggered by sneezing, exacerbated by a head cold, tripping or tipping the head back too far. It may present as a severe headache involving neck and shoulder stiffness and pain. The severe headache can be misdiagnosed as migraine or cluster headaches. The pinched nerves and swelling can cause a cycle of muscle spasms that cause pain and move the bones out of alignment.
Lumbar spinal stenosis is often diagnosed between L3 and L5 but can spread to other vertebrae. It affects the lower back, hips and legs, causing weakness, tingling, numbness resulting in difficulty walking, leg pain and/or limping. Treatment Options Depending on the level of pain the patient is experiencing and the degree of progression, treatment may vary from prescription pain medication to epidural injections, radiofrequency or surgery.
A wet heat source (hydrocollator) or Tens machine can provide temporary relief from pain. A cervical neck traction device can alleviate neck pain by stretching the neck and decompressing the cervical vertebrae.
Effective for short term treatment, pain medications are addictive and can cause stomach and liver problems. Some physicians prescribe muscle relaxers before bedtime.
Epidural Injections: This procedure involves the injection of cortisone into the affected area of the dura. Effective for up to 6 months. When radiofrequency is recommended, insurance companies often require patients first undergo epidural injections to determine if radiofrequency will be effective.
Radiofrequency: In this procedure, the nerve is singed, blocking pain for 6 months or more.
When surgery is recommended, laminectomy is a commonly performed procedure. Today, this is done with small incisions to the affected areas to remove the bony compression.
