As people age, one common spinal issue that can negatively impact life is spinal stenosis. According to research published by the Journal of the American Medical Association, lumbar spinal stenosis affects about 11% of older Americans. However, it does not negatively affect everyone who has it.
While research shows that about 20% of adults over the age of 60 have spinal stenosis. When it does affect a person, the symptoms can be mild to severe. Treatments depend on the severity of the spinal stenosis pain and symptoms. If you have been diagnosed with this condition or think you may have it, discuss your options with a doctor before you commit to any treatment.
What Is Spinal Stenosis?
Stenosis of the spine occurs when the spinal canal narrows. It means that the space inside the backbone is no longer large enough. In most cases, it occurs in the lower portion of the back or in the neck. It can also happen in the upper back. The spinal cord or nerve roots become compressed and may cause a variety of symptoms, which can vary with the location of the stenosis. In the vertebral canal, three sites may be affected by stenosis.
Central Canal
The first site is the central canal, which houses your spinal cord. If the canal narrows, it compresses neural elements and reduces blood flow to the spinal cord in the neck and lower back areas. Injury, infections, and various degenerative tissue changes can lead to central canal stenosis.
Neural Foramina
The openings where spinal cord nerve roots exit, which are called neural foramina, can also be affected. Compression can occur in neural foramina because of facet joint and ligament hypertrophy, disk herniation, slipped vertebrae, or other causes.
Lateral Recess
The lateral recess, which is also called Lee’s entrance, is a pathway for nerves near the spinal root in the spinal canal. It is in the lower back, and stenosis can happen as a result of facet joint hypertrophy or bone changes.
Common Symptoms Of Stenosis
When symptoms worsen, they can lead to a decrease in physical activity. These are some of the most common symptoms:
- Chronic lower back pain
- Leg pain
- Numbness in feet or legs
- Tingling in feet or legs
- Difficulty walking
With leg pain, many people who have stenosis say that it happens when they walk or stand for long periods. The symptoms may improve when they sit or bend forward. When stenosis affects the neck, other potential symptoms may be bladder or bowel problems and neck pain.
Risk Factors For Stenosis
People with hypertension, scoliosis, or other spinal issues may have a higher risk of developing stenosis of the spine. Even without these risk factors, some people develop stenosis as they age. The condition is most common among adults over the age of 50.
How Do I Know If I Have Spinal Stenosis?
If you experience any of the symptoms listed earlier, you may have stenosis. However, there are other potential issues as well. Whenever you experience any of those symptoms, it is important to consult with a doctor as quickly as possible. Your doctor will ask about your medical history, discuss your specific symptoms, perform a physical exam, and order imaging tests. These are some types of imaging doctors may use:
- X-rays come with minor exposure to radiation, and they can show bone spurs, bony alterations, and narrowed disc space of the spine.
- MRIs use strong radio and magnet waves to create cross-sectional spine images, and they can show points of spinal cord nerve compression, disc damage, ligament damage, and more.
- CT myelograms are often used for people when an MRI is not an option, and they combine X-ray images from various angles to show locations of spinal compression.
What Is The Best Painkiller For Spinal Stenosis Pain?
Because of the risks of dependency and misuse, opioids are not recommended for treating spinal stenosis pain. NSAIDs, membrane stabilizers, and other analgesics are commonly recommended. These are the most common painkillers doctors recommend or prescribe for treating spinal stenosis pain:
- Acetaminophen is an over-the-counter analgesic that treats pain but not inflammation, and it may be recommended for someone with milder pain who cannot take NSAIDs.
- NSAIDs like naproxen sodium and ibuprofen are over-the-counter painkillers that can help reduce inflammation and pain.
- Muscle relaxant medications like Cylobenzaprine, Baclofen or others can facilitate back pain recovery.
- Certain tricyclic antidepressants like amitriptyline can help alleviate chronic pain by adjusting neurotransmitter responses in the brain.
- Some membrane stabilizers like gabapentin create a nerve block effect that can help treat neuropathic pain.
Some anticonvulsants may also be used since they alter nerve functions that relate to pain. However, they cannot be used on a long-term basis. Trigger point injections may also be used to relax muscles that cause nerve irritation and referred pain. Other approaches may be considered if painkillers and lifestyle changes are ineffective.
Spinal Stenosis Treatment And Pain Management In The Chicago Metro
For any mild to severe pain, see a doctor for an evaluation and treatment suggestions. A custom treatment strategy is important. The plan your doctor suggests will depend on your health history, symptoms, and other factors. Also, the best painkiller for you depends on your individual needs and symptoms.
Dr. Macrinici specializes in helping people with spinal stenosis pain alleviate their discomfort and live a fuller life free of pain. He is triple board certified in pain management, anesthesiology, and spinal cord injury medicine. Please contact Advanced Pain & Spine Management in Arlington Heights to schedule an appointment.