Low back pain and neck pain may be related to the same condition. Spinal stenosis happens when the spaces in your spine become narrowed, which can pinch nerves and cause neck pain, low back pain, numbness, weakness, and that tingling pins and needles feeling. The problem is that there are many different conditions that can cause pains in the neck and low back regions. Visit the rehabilitation center and meet our pain specialists who can pinpoint the source of your pain and prescribe a personalized, time-tested treatment plan that works.
If you live in the New York City area, a visit to Downtown Pain Physicians will ensure you get the right diagnosis so an effective treatment plan can be set in motion. By listening and getting a thorough history of your pain and other symptoms our doctors have an idea of what path to follow. They will then use state-of-the-art diagnostic equipment to pinpoint the problem and customize a treatment plan just for you.
What is Spinal Stenosis?
Your spine serves as protection for your spinal cord, which runs through the middle of the backbone with nerves darting out through small openings or foramina. When those openings or the center of the spine itself becomes compressed or smaller, you can develop stenosis. Spinal stenosis can be categorized in a few different ways.
- Central Canal Stenosis. This is when the center of your backbone, the canal that the spinal cord runs through is compressed or there is inflammation of the spinal cord itself.
- Foraminal Stenosis. Foraminal stenosis is also called lateral stenosis, it’s when the small bony openings in your spine are narrowed and the nerves that branch out there get pinched. When you hear someone say they have a “pinched nerve,” it could be caused by foraminal stenosis.
There’s also another way to classify spinal stenosis, not by the part of the spine that’s compressed, but by the area of the body where the compression occurs.
- Cervical Stenosis. Anything in the cervical region of your spine is considered your neck area. If you have narrowing in the cervical area it is called cervical stenosis.
- Lumbar Stenosis. Your lumbar region is your low back, so narrowing of the spinal canal or the foramen in that area is referred to as lumbar stenosis.
The middle of your back, the thoracic spine, rarely experiences stenosis, which is why there isn’t a classification for thoracic stenosis.
What Are the Symptoms of Spinal Stenosis?
When you have spinal stenosis, your nerves simply don’t have enough room to effectively relay messages throughout your body. In response, they relay messages of pain, numbness, tingling, and weakness.
Because spinal stenosis tends to happen in the neck and low back region, the symptoms tend to be localized.
Cervical Stenosis Symptoms
- Neck pain.
- Numbness or tingling in arm or hand.
- Sometimes tingling and numbness in the leg and foot is related to cervical stenosis.
- Problems with balance or walking.
- Very severe cases may present with bowel or bladder urgency and/or incontinence.
Lumbar Stenosis Symptoms
- Lower back pain.
- Numbness or tingling in the leg or foot.
- A feeling of weakness in a leg (typically this occurs on one side, not both).
- Pain or cramping in the legs when you sit or stand for a long time. This can occur in both legs and is typically relieved by movement or sitting.
Interestingly, some people don’t have any symptoms. These people are typically in the beginning stages of spinal stenosis and as this condition progresses, they’ll begin to experience symptoms. The onset of spinal stenosis usually has the following characteristics, growing more consistent and persistent as time goes on.
- Pain, numbness, and tingling all start slowly. It’s not uncommon to have a little ache or tingle that’s barely perceptible and fleeting.
- The inconsistency of the onset makes it difficult to pin down. It can be there one moment and then gone a little while later.
- The symptoms seem to be related to certain activities or positions. The onset of spinal stenosis might be more apparent when you’re moving or positioned in a way that puts even more pressure on the affected nerves.
- Similarly, feeling relief from sitting, lying down, or stretching can be a sign that your nerves are stressed in one position but relieved in another.
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Causes of Spinal Stenosis
Some people are born with a smaller spinal canal, which leaves them predisposed to having “pinched nerves” and the associated pain and other symptoms. But in most cases, something occurs which causes a narrowing in the spinal canal or in the foramen.
- Spinal injuries. A car accident, a fall, or any other trauma can lead to a spinal injury that affects the passageways your nerves use. Even swelling from an injury can temporarily cause stenosis symptoms.
- Herniated discs. Between your vertebrae are little discs that act as shock absorbers. You can suffer a herniated disc or a slipped disc in many different ways, but the older you are, the more at risk you are for this condition.
- Thickened ligaments. Over time your ligaments can become stiff and thicken. If this happens, they may impinge on the space available in your spinal canal.
- Wear and tear on your bones from osteoarthritis can prompt the growth of bone spurs. These spurs can crop up in the spinal canal and next to the foramen, restricting your nerves.
- Paget’s disease. If you have Paget’s disease, it can cause bony overgrowth in the spine, which may affect your nerves and their function.
- Tumors and other growths inside the spinal cord are uncommon but can present problems.
Spinal Stenosis Risk Factors
Spinal stenosis is a condition that doesn’t have any risk factors that you can identify and then try to avoid. Age is the largest risk factor and becomes more of an issue after the age of 50.
Degenerative changes play hand-in-hand with age, but these changes can occur in the spine and bones before the age of 50. Trauma, injury, disease, congenital spinal deformities, and genetic bone diseases can also lead to spinal stenosis or make you predisposed to developing it in the future.
Diagnosis of Spinal Stenosis
If you have the following conditions, they can be caused by spinal stenosis. It’s also common, when you receive a diagnosis of spinal stenosis, to hear the following terms. These are integrated symptoms and if the cause is spinal stenosis, they will most often be relieved by addressing your stenosis.
- Radicular pain. This is pain that starts in your spine, at the region of the spinal stenosis, and reaches out into the arms and legs. Pain can be mild or severe and may also include a burning sensation or something that feels like electric shocks.
- With radiculopathy there are neurological deficits that can include tingling, numbness, and even a feeling of weakness in the arm(s) and/or leg(s).
- Myelopathy is a disorder in the spine that is caused by nerve or spinal cord compression. It is often paired with spinal stenosis.
- Cauda equina syndrome. The cauda equina is the spinal roots in your body that grow below the spinal cord. When they are compressed you can develop cauda equina syndrome, which includes numbness in your lower extremities, incontinence, difficulty walking, and other physical problems. Immediate treatment is necessary if this the diagnosis, whether it’s caused by spinal stenosis or not.
Ways to Diagnosis Spinal Stenosis
If you suspect spinal stenosis, a visit with Downtown Pain Physicians will help you confirm your diagnosis or determine what is actually causing your symptoms. When you come to our offices, you can expect to have a thorough conversation with your doctor so a patient history can be developed. Then, you may have one or more of the following diagnostic tests:
- Physical Examination. By palpating or gently touching the area and testing muscle strength, your doctor can get a better idea of what is happening with your spine.
- X-rays. Taking x-rays gives your doctor a better view of your spine and can highlight any abnormalities.
- CT scans. A CT scan can provide a more detailed look at what is happening in your spine and the small foramen openings.
- MRI scans. An MRI can give doctors a view of your nerve roots and other soft tissues so they can look for damage.
- Electromyography (EMG). An EMG shows how your muscles work when they are at rest and when they’re being used. This can detect muscle inefficiencies or weaknesses. EMG evaluation is done in our office, book an appointment today.
Spinal Stenosis Treatment Options
In extreme situations, surgery might be necessary to create more space for your nerves or your spinal cord. But there are other options for most people that are less invasive and can provide significant relief. At Downtown Pain Physicians, a combination of approaches will be used to customize a treatment plan that will give you the best results possible. Some options for treatment of your spinal stenosis may include:
- Physical therapy and muscle exercises
- Chiropractic treatments to realign any spinal subluxations
- Over-the-counter or prescription medications
- Trigger point injections
- Epidural steroid injections
- Medial branch block injections
- Facet joint injections
- Radiofrequency Ablation
- Selective Nerve Root Block
- MILD® Procedure
- Spinal Cord Stimulation
The staff at Downtown Pain Physicians specializes in helping patients recover from spinal pain and conditions related to the spine. They will begin by making you feel completely welcome and comfortable in our offices. We pride ourselves on short wait times so our patients don’t have to sit or stand for long periods, which can exacerbate their symptoms.
When you meet with your doctor, you’ll work together to discuss the symptoms you are having and what the best treatment options are for you. Your entire treatment plan will be explained to you and will be customized for your diagnosis and lifestyle. Your doctor’s goal is to create the most effective, yet least invasive treatment plan possible.
The information on this website is to provide general information. In no way does any of the information provided reflect definitive treatment advice. It is essential to consult a best-in-class pain management specialist in New York regarding ANY questions or issues. A thorough evaluation should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call your pain doctor to schedule a consultation.
Dr. Raj Raval, M.D.
- Board Certified
- Interventional Pain & Musculoskeletal Medicine Specialist
Education & training
- SUNY Downstate PMR Residency
- Rutgers University Fellowship