Spinal stenosis is a common inevitability to experience as people get older and the worst forms are typically found in elderly patients. As with most other structural abnormalities in the vertebral column, stenosis can be misidentified as a source of pain, thereby acting as a sciatica scapegoat. However, unlike some of the more benign irregularities, spinal canal stenosis can also be a horrifically symptomatic condition and a dire health threat. The clinical profile of central canal narrowing ranges from completely innocent to virtually life threatening.
This article details stenotic change in the spine and how this narrowing of the central canal can elicit a wide spectrum of possible symptoms. Sciatica can result from lumbar stenosis, but can also be caused by similar changes in the upper regions of the vertebral column. This fact is crucial to understand, since many patients with misdiagnosed sciatic nerve symptoms are actually suffering from cervical stenosis as their actual symptom generator.
Stenosis describes the narrowing of any anatomical space. In the case of the spinal variety, the space is the central spinal canal. This canal is the structure which surrounds the actual spinal cord and nerves. In a stenosis syndrome, some structure or process causes a constriction of this space, lessening the room available for proper spinal cord and spinal nerve root functionality.
Most stenosis conditions are minor and might be completely asymptomatic, but some can cause truly nightmarish problems when the actual neurological function of the cord is significantly impaired.
It must be reiterated that some degree of stenotic
change is both expected and universal as people age, so being diagnosed
with stenosis in the lower back or neck should come as no surprise to
patients over the age of 40 to 50.
Learn everything about spinal stenosis, including the symptoms, causes and treatment options, on Spinal-Stenosis-Treatment.Org.
The spinal canal can be narrowed by any number of common conditions. Some of the most typical sources of stenosis include:
Congenital canal narrowing is commonplace and is usually no cause for alarm. However, a congenitally narrowed canal is often more susceptible to further structural stenotic changes with age and degeneration, possibly becoming symptomatic sooner than a typical sized canal.
Cyst or tumor formation within the central canal, or outside but still enacting a mass effect on the canal space, can cause stenosis.
Herniated discs can occasionally bulge directly into the central canal. Most herniations can not cause complete stenosis by themselves, but may contribute to it when combined with ligament inflammation or arthritic change.
Spondylolisthesis can cause stenosis when the vertebral slippage is severe. In these instances, the central canal simply does not line up properly.
Osteoarthritis enacts bone spur formation and can produce arthritic debris which is the most common source of severe canal impingement.
Multiple vertebral fractures can create stenosis and overall spinal instability.
As with many other spinal abnormalities, stenosis is diagnosed far more often than it actually occurs in problematic form. Many cases are considered normal for a person’s age and activity level, yet might be vilified into taking the blame for painful sciatica symptoms. Many diagnostic MRI results show some degree of stenotic change, ranging from mild to severe, in patients with absolutely no symptoms.
Truly symptomatic stenosis of the spinal canal involves an obvious compression of the spinal cord, or cauda equina, and unmistakable symptoms, including severe pain, neurological dysfunction and possible loss of functionality in the legs, anus or genitals. When this occurs in the lumbar spine, cauda equina syndrome or even partial paralysis might result in extreme circumstances.
Some cases of incidental stenosis are simply spinal scapegoat conditions used to illogically explain sciatica pain which is actually being caused by some other undiagnosed source. Remember, a narrowed spinal canal means nothing by itself. Symptoms will not occur unless the nerves or spinal cord are actually compressed enough to warrant symptoms.
In essence, just because you have stenosis does not mean that it is the source of your sciatica, but it may be. Your neurologist is best suited to ascertain whether the condition is causative, contributory or circumstantial to any sciatica you might have.
For patients with the symptomatic central stenosis, my heart goes out to you. True stenosis can be a torture to endure and often involves drastic and even surgical treatment. It is even worse that so many patients with such relatively minor and completely asymptomatic stenotic changes share your diagnosis out of medical error, or more commonly, purposeful diagnostic exaggeration for the sake of money-making.
Remember also, that treatment is often conservative and illogical for stenosis. If the condition is defined as compression of the spinal cord or nerves, then it seems that in order to cure it, decompression will be needed. Keep this in mind when seeking care, since so many therapies fall into the symptomatic classification and will never provide a lasting cure. Instead, they will only help the patient cope with the symptoms while making them a slave to ongoing care.