Spinal Stenosis and Back Pain

A new study produced in January 2016 (Cochrane Database Syst Rev. 2016 Jan 29;1:CD010264. doi: 10.1002/14651858.CD010264.pub2) finds “no clear benefits were observed with surgery versus non-surgical treatment” for those suffering back or neck pain due to spinal stenosis.

spinal stenosisSpinal stenosis is a condition where the spine becomes narrowed in one or more of three parts:

  • The space at the center of the spine
  • The canals where nerves branch out from the spine
  • The space between vertebrae (the bones of the spine).

This narrowing puts pressure on the spinal cord and nerves and can cause pain. Stenosis is most common in men and women over 50 years old although younger people who were born with a narrow spinal canal or who hurt their spines may also develop the condition. Changes that occur in the spine as people get older are the most common cause of spinal stenosis. As people get older the soft tissue surrounding the spine providing it support may become thick and hard. Bones and joints may change shape due to arthritic or osteoporotic changes.

Stenosis itself can be asymptomatic, meaning there are no symptoms. However, as the condition progresses and the spine narrows further impeding the nerves symptoms may appear slowly and get worse over time. symptoms include:

  • Pain in the neck or back
  • Numbness, weakness, cramping, or pain in the arms or legs
  • Pain going down the leg
  • One type of spinal stenosis, cauda equine syndrome, is very serious. This type occurs when there is pressure on nerves in the lower back. Symptoms may include:
  • Loss of control of the bowel or bladder
  • Pain, weakness, or loss of feeling in one or both legs.

If you have any of these symptoms, you should call your doctor right away.

Stenosis can be in part diagnosed from the symptoms and movement patterns that are associated with the condition. However the only true way of confirming a diagnosis is through imaging, the most common of which is Magnetic resonance imaging (MRI).

Zaina et al. 2016 carried out a study comparing the success of surgical intervention for stenosis vs. conservative non surgical intervention. The results of the study showed no benefits from surgery when compared to non surgical treatment. It was noted however that “the rate of side effects ranged from 10% to 24% in surgical cases, and no side effects were reported for any conservative treatment”. As such the study highlights how clinicians should be careful in considering which patients they refer on for surgery for treating stenosis.

Here at the Buckingham Clinic our IDD machines provide a very effective alternative to surgical intervention. We have had much success treating a variety of back pain conditions including treatment of stenosis! Why not contact us for an appointment?

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