Ways to diagnose and treat Spinal Stenosis

 Spinal stenosis is a narrowing of the gaps in your spine, putting pressure on the nerves that run through it. The lower back and neck are the most common sites for spinal stenosis.

Some people with spinal stenosis don't show any signs or symptoms. Pressure, tingling, numbness, and muscle fatigue can be experienced by others. Symptoms can become more severe over time. Wear-and-tear changes in the spine caused by osteoarthritis are the most common cause of spinal stenosis. Doctors may suggest surgery to create more room for the spinal cord or nerves in serious cases of spinal stenosis.

 

Symptoms

Many people with spinal stenosis have signs of it on an MRI or CT scan but no symptoms. When they do happen, they usually start slowly and get worse over time. The symptoms differ depending on where the stenosis is located and the nerves are affected.

 Cause

Wear-and-tear changes in the spine caused by osteoarthritis are the most common cause of spinal stenosis. Doctors may suggest surgery to create more room for the spinal cord or nerves in serious cases of spinal stenosis.

Diagnosis

Your doctor can ask you about your signs and symptoms, discuss your medical history, and perform a physical examination to diagnose spinal stenosis. To help pinpoint the cause of your signs and symptoms, he or she can order several imaging tests.

 These assessments can include the following:

  •  X-rays are a form of x-ray. Bony modifications, such as bone spurs, can be seen on an X-ray of the spine, which could be narrowing the space inside the spinal canal. Each X-ray exposes you to a small amount of radiation.

  • Magnetic resonance imaging (MRI) is a form of imaging that (MRI). An MRI creates cross-sectional images of the spine using a strong magnet and radio waves. Damage to your discs and ligaments, as well as the presence of tumours, can all be detected with this examination. Most importantly, it will reveal where strain is being placed on the nerves in the spinal cord.

  • CT scan, also known as a CT myelogram. If an MRI isn't an option, your doctor can suggest a CT scan, which combines X-ray images taken from a variety of angles to provide accurate cross-sectional images of your body. A CT scan is performed after a contrast dye is inserted in a CT myelogram. The dye will expose herniated discs, bone spurs, and tumours by highlighting the spinal cord and nerves.

 Treatment

Treatment for spinal stenosis is determined by the severity of the symptoms and the position of the stenosis.

Consult your doctor to determine the right course of action for you. If your symptoms are minor or you don't have any, your doctor will want to keep track of your progress with daily follow-up appointments. He or she can provide you with some self-care suggestions that you can implement at home. He or she can prescribe medications or physical therapy if these don't work. If other therapies have failed, surgery may be an option.

 Medication

Your doctor may prescribe:

  • Pain Relievers. Ibuprofen (Advil, Motrin IB, others), naproxen (Aleve, others), and acetaminophen (Tylenol, others) are all pain relievers that can be used to temporarily relieve the pressure of spinal stenosis. They're usually only recommended for a limited period of time because long-term usage hasn't been shown to be beneficial.

  • Antidepressants are medications that are used to treat depression. Tricyclic antidepressants, such as amitriptyline, can be used at night to cope with chronic pain.

  • Anti-seizure medications. Gabapentin (Neurontin) and pregabalin (Lyrica), two anti-seizure medications, are used to treat pain caused by damaged nerves.

 Physical Therapy

People with spinal stenosis also become less active in order to alleviate pain. However, this can result in muscle fatigue, which can lead to more discomfort. Exercises that a physical therapist will give you include:

  • Strengthen and extend your stamina.

  • Maintain the spine's versatility and stability.

  • Boost your equilibrium.

 Steroid Injection

In the areas where your nerve roots are pinched, they can become irritated and swollen. Although injecting a steroid drug (corticosteroid) into the space around the impingement will not cure the stenosis, it will help to alleviate inflammation and pain.

Injections of steroid hormones do not function for everyone. Since frequent steroid injections may damage surrounding bones and connective tissue, these injections should only be done a few times a year.

Decompression Procedure  

To improve spinal canal space and remove nerve root impingement, needle-like devices are used to remove a portion of a thickened ligament in the back of the spinal column. This form of decompression is only for patients who have lumbar spinal stenosis and a thickened ligament.

Percutaneous image-guided lumbar decompression is the name of the technique (PILD). It's also known as minimally invasive lumbar decompression (MILD), but physicians use the name PILD to prevent confusion with minimally invasive surgical procedures.

Since PILD does not require general anaesthesia, it may be a viable choice for certain people who are at high surgical risk due to other medical conditions.

Surgery

Surgery could be considered if other therapies haven't worked or if you're disabled by the symptoms. By making more room inside the spinal canal, the procedure aims to relieve pressure on the spinal cord or nerve roots. The most definitive way to try to resolve symptoms of spinal stenosis is surgery to decompress the region of stenosis.

According to research, when spine operations are performed by highly skilled surgeons, there are fewer complications. Ask your surgeon about his or her experience with spinal stenosis surgery. Get a second opinion if you have any questions.

Potential Future Treatment

Clinical studies are currently underway to see whether stem cells can be used to treat degenerative spinal disease, a technique known as regenerative medicine. There are also genomic medicine studies underway, which may lead to new gene therapies for spinal stenosis.

 Alternative medicine

Integrative medicine and alternative therapies may be used with conventional treatments to help you cope with spinal stenosis pain. Examples in

  • Massage therapy

  • Chiropractic treatment

  • Acupuncture

Talk with your doctor if you're interested in these treatment options.

 

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