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Main Line (Austin Area)
A man with back pain.

All About Spinal Stenosis: Causes, Treatments and Preventions

Interview with Dr. Adam W. Spjute, M.D.

Dr. Adam Spjute is a Double-Board-Certified Anesthesiologist and Pain Management Specialist at Advanced Pain Care in Waco.

Trained in anesthesiology, Dr. Spjute then did a fellowship training in pain management. Since then, he’s been practicing pain management for 5 years, treating chronic pain ranging from headaches and foot pain and everything in between.

He’s published studies in Anesthesia and Pain Management, was granted membership into the American Society of Anesthesiologists and the American Society of Regional Anesthesia and Pain Management, and helps patients in Advanced Pain Care’s Waco branch with their pain care needs.

So, Let’s Talk About Spinal Stenosis, Dr. Spjute. What is it?

Firstly, you’ll need to know that there are different parts of the spinal canal: a center part, and an inside part where the spinal cord goes. The spinal cord is surrounded by fluid, and outside that fluid is some space called the epidural space. Typically, it’s empty, but when spinal stenosis happens, the space narrows and adds pressure to your spinal cord.

Since your spinal cord is filled with nerves, it can affect your back as well as your arms, hands, legs, and feet.

After knowing all that, spinal stenosis should seem pretty simple: spinal stenosis is a condition where the spinal cord narrows. There are two different types of spinal stenosis: caused by problems in your back (like arthritis), or congenital spinal stenosis, which means that you’re born with a spine that doesn’t have much room.

You could also have spinal stenosis caused by disc bulges, which is when one of the discs between the bones ruptures the disc and creates spinal stenosis in your back. But what I primarily see as the most common type is when it’s caused by arthritis, in the joints.

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Spinal Stenosis Symptoms

Truth is, there are so many different types of back pain and symptoms out there, so it can be a little challenging to figure out if you have spinal stenosis– which is why it’s best to find a professional pain management clinic in your area to get a clearer understanding of what you’re dealing with.

With spinal stenosis, you’ll probably feel the most basic feeling of a back injury– back pain! But unlike some other chronic pain, you might also feel pain radiating down your legs or arms, which could increase during extended periods of walking and could feel relief when you’re leaning forward (because leaning forward opens up the space within the spinal column).

Here’s a little overview of all spinal stenosis symptoms:

  • Pain in the neck or back: This is one of the most common symptoms, which may vary from mild discomfort to severe pain. The pain can also eventually radiate to other parts of the body.
  • Numbness or tingling: These sensations can occur in the hands, arms, feet, or legs, depending on the location of the stenosis (and can sometimes be confused with other back injuries).
  • Weakness: This can occur in the muscles of the hands, arms, feet, or legs, which could either come and go or stay persistent.
  • Problems with walking and balance: The stenosis may affect the nerves that control your balance and coordination, leading to difficulty walking or frequent falls, especially when you’re walking long distances.
  • Pain going down the leg (sciatica): In lumbar stenosis, pressure on the lower spinal nerves can cause this symptom.
  • Loss of bowel or bladder control: In more severe cases, spinal stenosis can cause problems with bowel or bladder function, which is a medical emergency. This may indicate cauda equina syndrome, which requires urgent surgical intervention.
  • Claudication: This is a specific type of leg pain that occurs when walking or standing and typically improves with sitting or leaning forward. It can be a symptom of lumbar spinal stenosis.

Now, you might be thinking: pain in the back and going down your legs? Isn’t that sciatica? But the thing is, sciatica is a symptom. Kind of like when you have a runny nose– it could be allergies, or it could be a cold.

In this case, sciatica is the symptom of having pain shooting down the back of your leg in the same distribution of your sciatic nerve. Another cause could be from spinal stenosis.

So, the best way to tell is to get imaging, like an MRI or a CT scan, so you can really figure out if you have stenosis.

What’s Your Protocol and Treatment, and Does Spinal Stenosis Ever Heal Completely?

The approach to treating spinal stenosis and its potential for full recovery can vary greatly depending on the root cause of the condition!

For instance, let’s say a younger patient comes in with a disc bulge. They might typically be recommended for a more noninvasive approach like physical therapy so they can strengthen their muscles. If that doesn’t work, they could also get an epidural steroid injection, which is slightly more invasive but doesn’t require surgery if it’s effective.

Conversely, let’s say a patient comes in with extensive spinal arthritis. Reversing the condition can be a lot more challenging, both based on their age and their arthritis. Although the initial management may still include physical therapy and epidural injections, if these measures don’t yield their desired results, we’d often need to consider alternative treatments, like the use of a spinal cord stimulator or even resorting to surgical intervention.

Due to the limited blood flow to this area, the healing process can be slower, particularly in older patients, so multiple different more invasive treatments might need to be considered in order to manage it as best we can.

The amazing thing is, the human body possesses an incredible capacity for self-repair and can, over time, actually reabsorb such disc bulges on its own, if the patient wants to seek a more natural route!

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How Can I Prevent Getting Spinal Stenosis?

If you’re a younger patient, the best way to prevent spinal stenosis (and back injuries in general) is through lifting with your legs while keeping your back straight, and never over-exerting yourself.

If it’s caused by arthritis, there’s not much else you can do other than maintain a healthy diet and watch your weight so you can prevent it, and stretch or do yoga so you can be sure your muscles are always staying limber.

If you’re at the gym and you feel and hear a pop in your back, that’s usually indicative that you’ll have a disc bulge. As time goes on, those joints become deteriorated if you’re not taking care of your body– so stay healthy, maintain a good weight and diet, and lift properly, so you can ensure your back is always protected!