Spinal stenosis is a common condition affecting millions worldwide, and here in Vancouver, many active individuals experience its limitations. It’s one of those conditions you may have heard about, but understanding exactly what’s going on can be confusing. That’s because it’s both a spine and a nerve problem, and it can affect different people in different ways and with different symptoms. Simply put, spinal stenosis is a condition in which there has been narrowing of the spaces in your spine through which nerves pass. This includes the space through the center of your spine that encases your spinal cord, as well as the spaces in between your vertebrae, called, foramen, which allow nerves to pass from the spine to the rest of your body.
When one or more of these spaces become constricted, your spinal cord or the branching nerves become compressed, inflamed or pinched, which can cause pain and nerve problems. The most common areas of your spine for stenosis to occur is in your lower back (lumbar spine) and your neck (cervical spine). It’s rare, but possible to have stenosis in the middle of your back (thoracic spine).
While there are genetic and developmental conditions that can cause congenital spinal stenosis (from birth) in babies and children, most cases of stenosis occur as the result of aging. Over 90% of people over the age of 50 have some degenerative spinal changes, including stenosis. And among people over the age of 65 who have spinal surgery, the most common diagnosis is spinal stenosis.
The symptoms of spinal stenosis tend to develop slowly. In general, the most common symptoms of this condition include pain, numbness, tingling and weakness. The pain associated with stenosis can be dull and achy, sharp, electric-like sensations or burning. Though, it’s common to have vertebral changes show up on an X-Ray, but you may still be symptom-free.
When your low back is affected, you may feel the pain locally, or it may radiate through your buttocks, down your leg and even into your foot, or the sensation may be cramping, numb or tingling in those areas. With lumbar stenosis, it’s common to be able to stand or walk for several minutes, and then have pain, numbness and leg weakness that can only be alleviated by sitting, leaning forward, changing position or in some people, walking uphill. Cervical stenosis can cause neck pain, numbness, tingling and weakness in your arms or hands. It can also cause a loss of function or clumsiness in your hands, as well as balance problems.
The causes of acquired spinal stenosis (not from birth) include:
- Osteoarthritis. Over time, the wear and tear on the cartilage in all of your joints causes it to break down. Your spine is no exception. Cartilage is a protective and shock absorbing covering where bones rub against each other. When cartilage is worn away, your body tries to repair the damage by growing new bone, creating overgrowths called bone spurs. These bone spurs are a common cause of the narrowing in your spinal openings that cause stenosis.
- Disc degeneration. Your discs are a flat pad of fibrous tissue that act as a cushion between your vertebrae. With age, these discs become dry and flat, and they can bulge, crack or rupture allowing the gel-like center to escape. This can press on and cause damage to the surrounding nerves.
- Ligament damage. Like your discs, age, wear and tear can cause the fibrous bands that hold your joints together to thicken. In your back, these aging ligaments can weaken, causing structural changes or even protrude into your spinal canal.
- Spinal fractures and injuries can cause bone dislocation.
- Cysts or tumors are growths which have the ability to narrow the spaces through which your spinal nerves pass.
- Inflammation. Arthritis, injuries, disc problems and other conditions can cause inflammation, which may increase swelling, bone growth or deformation and further narrow spinal canals.
Treating Spinal Stenosis
For mild symptoms, most health care providers recommend at home care, which may include heat, cold and mild exercise. If symptoms are more severe, your doctor may prescribe over the counter NSAIDs (nonsteroidal anti-inflammatory meds), prescription medications, steroid injections and physical therapy. In some cases, surgery is an option, however it’s usually a consideration only when all other options have failed.
Many people with spinal stenosis symptoms seek out acupuncture to relieve their symptoms, for good reason. Acupuncture is well-known for its ability to relieve all types of pain and many research studies support its effectiveness in treating back and neck pain. Research on stenosis is ongoing, but scientists have found that acupuncture can reduce pain intensity and overall symptoms, improve quality of life and functional outcomes in patients with spinal stenosis. Acupuncture works for this condition in a number of ways. It increases circulation to bring blood and healing nutrients to the treatment area, decreases inflammation, increases the circulation of feel-good neurotransmitters, and ramps up your body’s own natural opioid system.
In addition to acupuncture, when I treat a patient with spinal stenosis, I may add other modalities such as shockwave and cold laser therapy to your treatment plan. However, it’s important to know that there are a few things that you can also do, such as:
- Work on having good posture.
- Do regular exercise to keep your back and core muscles strong and your spine healthy. I’m a big fan of Yoga and Pilates, especially for spine health.
- Eat good, whole foods, including those that give you calcium and magnesium to benefit your bones.
- Quit smoking. Believe it or not, smoking can contribute to back pain by damaging your blood vessels, making it harder for you to heal.
In a nutshell, spinal stenosis is a term for degenerative changes in your vertebrae that cause squeezing or pinching of your nerves. There are a number of natural and drug-free ways to manage this condition, including acupuncture. Please contact me if you’re tired of having back pain and are looking for a solution.
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Dr. Jeda Boughton is a Doctor of Traditional Chinese Medicine and Registered Acupuncturist in Vancouver. She is also a Registered Herbologist and the founder of BodaHealth.
