Just because you have stenosis does not mean you have a life-long sentence of living with pain. This blog will cover everything you need to know about stenosis including:
- Spinal stenosis treatment
- Stenosis causes
- Cervical canal stenosis
- Stenosis pain relief
- Stenosis surgery
- Stenosis exercise
What is Stenosis?
Stenosis means narrowing and can be in one of the two areas of the spine which this little bit of anatomy clarifies for you!
- Spinal Canal Stenosis: The spinal canal (see photo) is the hole in the center of the vertebrae where the spinal cord runs through. Narrowing of this canal directly affects the spinal cord and associated nerve distributions.
- Neural Foraminal Stenosis: The foramen (hole) is a tunnel created when two vertebrae are stacked on top of each other. This is where nerves stem from your spinal cord and distribute to the rest of the body. A narrowing of this space directly impacts the nerve at the level involved.
What Does Spinal Stenosis Feel Like?
Regardless of the type of stenosis, the narrowing leads to irritation of the cord or the nerves. But in neural foraminal stenosis, the nerve distribution affected is more specific to the location of the vertebrae impacted. This means that you will have a more clear pain distribution that follows a specific nerve pattern.
Stenosis can occur at any level of the spine but is typically seen in the lumbar (lower back) and cervical (neck) vertebrae. It can also occur at just one spinal level or multiple levels. Due to the varying locations of occurrence, symptoms will vary. For example, if the stenosis is at the lumbar level, symptoms like lower back pain and pain down the legs are common. If in the cervical region, then neck/upper back pain or pain down the arms can occur.
Lumbar stenosis symptoms are commonly mistaken for Sciatica or Piriformis syndrome with a whole different treatment protocol while pain down the arm can be present from pinched nerve, stenosis, or trigger point therapy. You may want to pause and read the blog I wrote on pinched nerve. While history and exam are important, the study to rule out stenosis vs other ‘imposters’ is an MRI of the area involved.
What Causes Stenosis?
Stenosis is a narrowing of the space where the nerve or cord goes through, but what causes the narrowing? The short answer is postural imbalances! Factors such as a lifestyle of sitting, repetitive movements, injuries, and one-sided sports can lead to the thickening of the ligaments inside the hole. Which leads to the actual narrowing of the hole where the nerves or cord go through.
For the sake of understanding let’s think of how a callus is formed on the hand! When there is no protection and the labor is hard and repetitive, over time callus is formed. Now, there is no such thing as a callus of the spinal cord or spinal nerves! But similar to a callus, the ligaments INSIDE the spinal canal, or the hole where the spinal nerve exits the vertebra can get thick. Typically this happens when the actual structure in that region has lost its stability due to the following:
- Bad lifestyle
- Loss of muscle tone
- Excess weight in the abdomen (lumbar stenosis)
- Prolonged sitting
- Prolonged standing
- Increased use of technology
- Weightlifting with bad form
- One-sided sports
- Car accident
- Postural decline
- Contact sports
These can cause the ligaments to endure undue stress. Not that these lifestyle factors directly cause stenosis, but these major factors place you on the road to developing stenosis or making stenosis become painful.
So how do we regain stabilization? It’s not by doing abdominal crunches, using weight, isolating the symptomatic area(s), and stretching. It is not by adjustment either! Some of the lifestyle contributory factors can be eliminated to give you a better chance, but what’s missing in most treatments is Functional Movement and Postural Neurology.
Stenosis Pain Relief and Treatment
If you have stenosis, don’t ever feel that you are stuck with this pain and need to learn to deal with it for the rest of your life. Don’t make yourself into a walking pharmacy and don’t think surgery is your only solution. Frankly, it is far from the solution!
Now, chiropractic adjustments won’t help you long-term either because adjustments or spinal manipulations simply activate your nervous system. And when you get physical therapy, movement is introduced; there is some relief because movement IS needed. Except, when the area or nearby areas are addressed and the pain is decreased the patient is released from care, but we are not finishing what is started. So what’s the right answer?
In the case of Stenosis, typically by the time patients come to my office, they have exhausted so many options and are almost hopeless. The major joints in movement, not necessarily the spine, are impacted due to the chronic nature of stenosis. So functional rehab therapies such as ART or Active Release Techniques need to be performed to restore proper function to affected areas. Meanwhile, we go back to what we all did as babies to develop functional movement patterns.
What this video to find out why!
By correcting the pathological patterns of movement you have developed and re-establishing the correct patterns in the brain, we have what it takes to not only treat your pain but prevent further damage, which brings me to the next question..
Can Stenosis Be Reversed?
Once stenosis is present it will not go away but it can certainly become ‘less loud’ with the right treatment. And most importantly, you can learn how to prevent it from getting worse by learning the do’s and don’ts of movement.
Symptom-free stenosis can be achieved by activating your stabilizing system to reestablish a strong foundation. And that starts with breathing! It’s no coincidence that the first sign of life in newborns is the first breath. Learn what proper breathing is in the video below.
With the correct breathing pattern, we can continue to build on that foundation adding other movements and loads. You can check out my YouTube channel under the playlist Functional movement and Postural Neurology to better understand what these exercises look like.
When to Have Stenosis Surgery
Surgery should not even come to mind unless you have tried Postural Neurology and Functional Movement. If you don’t want to put in the work, then this blog is not for you because even with surgery, the same principles have to be implemented or you will have pain and misery coming your way. Watch this video to understand what I am talking about.
It is not fun to live with pain, but that does not have to be your story and unless you like taking meds and having surgery, Stenosis is treatable. Remember, you are the Designer and the Director of your own life so design and direct it the way you wish to live it.
Yours for better health, always,
Mamak Shakib, DC