FAQ’s on Spinal Stenosis Treatment in Philadelphia
Stenosis is a term used to describe narrowing of the spinal canal. People at risk for spinal stenosis are those who are 50 years of age and older.
How common is spinal stenosis?
According to research, cervical spinal stenosis affects 5% of adults 50 years of age and older. For people who are older than 70 years, that rate increases to 9%. A study of more than 1,000 participants found that the prevalence rate of symptomatic lumbar spinal stenosis was also 9%, and it affected men slightly more often than women.
What causes spinal stenosis?
Narrowing of the spinal canal is the cause of spinal stenosis. The condition occurs due to arthritis, bone spurs, thickened ligaments, tumors, major spine trauma, and degenerative disc disease. When the canal narrows, the spinal nerves are compressed, causing pain. Pressure on the cervical (neck) nerves results in pain that radiates down the arms. Numbness and tingling can also occur. When the lower back (lumbar) spine is affected, these same symptoms occur in the lower extremities.
What are the risk factors associated with spinal stenosis?
People at risk for developing spinal stenosis include:
- Advancing age
- Being born with a narrow spinal canal
- Having surgery of the spine
- Having ankylosing spondylitis, spinal tumors, osteoarthritis, and Paget’s disease
What symptoms are associated with spinal stenosis?
In addition to pain of the back that radiates down the arms or legs, the patient may complain of pain with standing, walking, or lower back extension. Abnormal spine curvature is not uncommon, and lengthened hip muscles does occur.
How is spinal stenosis diagnosed?
When you arrive at the pain management center, the doctor will ask you several questions about your symptoms and take a medical history. Special tests are ordered to assess for spinal stenosis, such as x-rays of the spine to assess for bone spurs, canal narrowing, and arthritic changes, as well as magnetic resonance imaging to check the spinal cord and associated nerves. If there is severe nerve-related symptoms, the doctor may order an electromyogram.
What are the treatment options for spinal stenosis?
Spinal stenosis treatment depends on the severity of the disease, the extent of the damage, and the patient’s individual response to treatment. Therapies include:
- Medications – The pain management specialist may prescribe muscle relaxants, tricyclic antidepressants, anti-inflammatory agents, and/or analgesics. A combination of drugs is often used for this condition.
- Physical therapy – To improve the flexibility and strength of the back, the therapist teaches the patient stretching and strengthening exercises. Pain relief measures include electrical stimulation, massage, and ultrasound therapy.
- Facet joint injection (FJI) – The doctor will inject the tiny facet joints with an anesthetic agent, and sometimes, a corticosteroid. X-ray guidance is used to guide the needles into position. More than one joint is often injected during a procedure.
- Facet joint denervation – The doctor can use radiofrequency energy to destroy a portion of the nerve root. The special needle device has a tiny probe at the end of it that coagulates nerves. In a recent clinical study, this procedure had a 76% efficacy rate, and more than half of the patients reported complete symptom relief.
- Epidural steroid injection (ESI) – A corticosteroid can be injected into the epidural space that lies between the epidural layer and the spinal cord. A recent clinical study showed ESI to have an 85% success rate.
Kalichman L, Cole R, Kim DH, Li L, Suri P, Guermazi A, et al. (2009). Spinal stenosis prevalence and association with symptoms: the Framingham Study. Spine Journal, 9(7):545-50.
Lee MJ, Cassinelli EH, & Riew KD (2007). Prevalence of cervical spine stenosis. Anatomic study in cadavers. Journal of Bone and Joint Surgery, 89(2), 376-380.
McLain, RF, Kapural L, & Mekhail NA (2005). Epidural steroid therapy for back and leg pain: mechanism of action and efficacy. Spine Journal, 5:191-201
Streitberger, K, Muller, T, Eichenberger, U, et al. (2011). Factors determining the success of radiofrequency denervation in lumbar facet joint pain: a prospective study. European Spine Journal, 20(12), 2160-2165. doi: 10.1007/s00586-011-1891-6