SPINAL STENOSIS

Definition: 

Constriction or narrowing of a passageway or opening, such as the spinal canal when a disc herniates and causes the canal to become smaller. Stenosis can also be caused gentically. In the congenital stenosis, see picture, the fact that there is narrowing of the spinal canal, indicates that a disc herniation in that area will have a greater detrimental effect because there is no room in the spinal canal and can cause greater insult on the spinal cord or nerve roots. In this instance, a congenital problem has predisposed the client or patient to greater bodily damage with trauma. 

Symptoms:

Spinal narrowing doesn't always cause problems. But if the narrowed areas compress the spinal cord or spinal nerves, you're likely to develop signs and symptoms. These often start gradually and grow worse over time. The most common spinal stenosis symptoms include:

• Pain or cramping in your legs. Compressed nerves in your lower (lumbar) spine can lead to a condition called pseudoclaudication, false claudication or neurogenic intermittent claudication, which causes pain or cramping in your legs when you stand for long periods of time or when you walk. The discomfort usually eases when you bend forward or sit down, but it persists if you continue to stand upright.

  Another type of intermittent claudication (vascular claudication) occurs when there's a narrowing or blockage in the arteries in your legs.

  Although both types of claudication cause similar symptoms, they differ in two important ways: Vascular claudication becomes worse when you walk uphill and improves when you stand still. Pseudoclaudication is usually worse when going downhill and gets better when you lean forward or sit down.

• Radiating back and hip pain. A herniated disk can narrow your spinal canal and compress nerves in your lumbar spine, leading to pain that starts in your hip or buttocks and extends down the back of your leg. The pain is worse when you're sitting and generally affects only one side.

  You may also experience numbness, weakness or tingling in your leg or foot. For some people, the radiating pain is a minor annoyance, but for others, it can be debilitating.

• Pain in your neck and shoulders. This is likely to occur when the nerves in your neck (cervical spine) are compressed. The pain may occur only occasionally or it may be chronic, and it sometimes can extend into your arm or hand. In addition, the spinal cord is sometimes compressed, which can result in lower extremity weakness and difficulty walking. You also may experience headaches, a loss of sensation or muscle weakness.
• Loss of balance. Pressure on the cervical spinal cord can affect the nerves that control your balance, resulting in clumsiness or a tendency to fall.
• Loss of bowel or bladder function (cauda equina syndrome). In severe cases, nerves to your bladder or bowel may be affected, leading to partial or complete urinary or fecal incontinence. If you experience either of these problems, seek medical care right away.

From:  http://www.mayoclinic.com/health/spinal-stenosis/DS00515/DSECTION=symptoms

Treatment:

Flexion-Distraction of the spine to open up the vertebral bodies and take pressure off of the spinal cord. 

Core Stability Exercises:  This is necessary to strengthen the area around the spine to reduce the stress on the cord when you move.

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  “Clinically correlating causality to bodily injury and persistent functional loss.”

Dr. Bryan Dingsor is the owner of Watertown Chiropractic P.C. in Watertown, SD.