Spinal stenosis is a condition that results from the narrowing of the spinal canal, which causes pain due to impingement of the spinal cord and associated nerves. Pain experienced as a result of spinal stenosis usually affects the lower back and lower extremities and often results in difficulty walking, a decrease in sensation in the lower extremities, and a reduction in physical activity. People affected by spinal stenosis are usually over 65. Scoliosis and hypertension are both considered risk factors. Interestingly, advancing in age makes a person more likely to be affected without any pre-existing pathology.
Spinal stenosis is often a result of bulging discs or discs becoming herniated, but can also be a result of arthritic deterioration. In any case, spinal stenosis tends to cause disability due to the pain and reduction of mobility seen often in spinal stenosis cases. Central sensitization is a complication that often accompanies spinal stenosis. Central sensitization is the development of both the central nervous system (CNS) and the peripheral nervous system (PNS). Injury and inflammation activate the PNS, which sends signals to the brain through the spinal cord. When central sensitization occurs, there is increased excitability of the CNS’s neurons, causing normal inputs from the peripheral nervous system to produce abnormal, often painful, responses. Allodynia is characterized by minor stimuli (such as the wind blowing against the skin) causing pain symptoms. Hyperalgesia is characterized by a normally painful stimulus (bumping against something) that causes much higher levels of pain than would normally be felt.
In order to diagnose a patient with spinal stenosis, a physician will first perform a physical exam focusing on tenderness over areas of the spine and possible limitations of movement in the lower extremities. Radiological imaging will likely be ordered to check the level of stenosis. An MRI is the most common radiological imaging used to visualize back pain and is especially useful before a procedure. Fluoroscopic imaging often is used during a procedure.
There are several ways to treat spinal stenosis using interventional and pharmacological options. Some of the medications that will likely be used include NSAIDs (such as ibuprofen or naproxen), membrane stabilizing drugs, and other over-the-counter or prescription pain relievers. Some of the interventions that can be used to reduce symptoms include:
For more information on how we can help treat your spinal stenosis pain, please contact us at 470-424-8888.
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