Spinal stenosis is a condition where the open spaces in the spine become narrow, limiting the space for nerves that travel through the spine. As the spine narrows, it can begin to crowd and compress nerves, resulting in a wide array of symptoms. While some people may be born with unusually narrow spinal spaces, most spinal stenosis occurs as a result of age-related degeneration of the spine or from injuries. Sometimes, patients with arthritis in the spine form bone spurs that can wind up invading the spinal space. In a few cases, stenosis can be caused by tumors. Spinal stenosis usually occurs in the neck (the cervical spine) and the lower back (the lumbar spine).
Some people with mild stenosis may have no symptoms at all, while more severe cases of stenosis can cause pain, numbness, tingling and muscle weakness in the arms or legs. When the condition is very severe, the nerves that control the bladder and bowel can be affected, resulting in urinary or bowel incontinence (or both). Most symptoms begin gradually and become worse over time. Some patients find temporary relief when sitting down and leaning forward.
The symptoms of spinal stenosis can be very similar to other spinal diseases, which can make diagnosis especially difficult. In addition to an examination of the back and a careful review of symptoms, imaging tests including x-rays, MRIs, and CT scans are often used to confirm the diagnosis.
Some mild forms of spinal stenosis may be treated with conservative approaches including physical therapy and medication to reduce pain and inflammation. As the condition progresses, injections of corticosteroids and other medications can be very helpful in controlling painful symptoms. Injections are made into the epidural space, outside the spinal cord. A contrast solution is used to ensure the medication is effectively delivered to the treatment area. During the treatment, real-time x-ray imaging is used to ensure proper placement of the needle and medication.
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