Spinal Stenosis

Written by Dr. Jason Ngan

What is Spinal Stenosis?

Spinal stenosis is the narrowing of the space where the spinal cord is located.. The spinal cord is a column of nerves that comes from the brain and branch out to the rest of the body. These nerves are responsible for movement and sensation, therefore when they are compromised, it will cause weakness and pain. Spinal stenosis usually occurs in the neck and low back.

What Causes Spinal Stenosis?

Spinal stenosis can be caused by multiple factors. Basically anything that takes up space in the spinal column causes stenosis.

What are the Signs and Symptoms?

  • Pain, numbness, tingling, weakness that travels to the arms or legs

  • Weakness in the arms or legs

  • Symptoms worsen with movement, coughing, sneezing, or performing a bowel movement.

  • In severe situations, bowel and bladder function is disrupted. This can be a sign of cauda equina syndrome and would require an emergency room visit.

How is Spinal Stenosis Diagnosed?

Spinal stenosis is diagnosed with a thorough medical history, physical examination, orthopedic testing, x-ray diagnostic imaging, CT scan, and MRI.

  • X-ray, CT, MRI is used to visualize the affected space. X-ray and CT can detect bony changes while MRI is better suited for viewing soft tissue.

  • Muscle weakness.

  • Abnormal sensation (pain, numbness, tingling).

What are the Treatment Options?

  • Chiropractic manipulation and mobilization

  • Flexion-distraction

  • Spinal traction

  • Soft tissue therapies

  • Gua-sha

  • Cupping

  • E-stim

  • Ultrasound

  • Ergonomic/postural counseling

  • Rehabilitative exercises

Other treatments that patients may seek (not provided at Ngan Chiropractic) include anti-inflammatory medication, epidural steroid injections, and surgery if severe.  

References

  1. Raja A, Hoang S, Patel P, et al. Spinal Stenosis. [Updated 2022 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441989/

  2. Bagley C, MacAllister M, Dosselman L, Moreno J, Aoun SG, El Ahmadieh TY. Current concepts and recent advances in understanding and managing lumbar spine stenosis. F1000Res. 2019 Jan 31;8:F1000 Faculty Rev-137. doi: 10.12688/f1000research.16082.1. PMID: 30774933; PMCID: PMC6357993.

  3. Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA. 2022;327(17):1688–1699. doi:10.1001/jama.2022.5921

  4. Wu AM, Zou F, Cao Y, Xia DD, He W, Zhu B, Chen D, Ni WF, Wang XY, Kwan K. Lumbar spinal stenosis: an update on the epidemiology, diagnosis and treatment. AME Med J 2017;2:63.