Chiropractic treatment of spinal stenosis is safe and effective.
Posted Nov 30 2009 10:02pm
In my Chiropractic practice, I frequently see patients with spinal stenosis. I want to use this column to explain what it is, what some symptoms are and review the treatment options available.
By definition, spinal stenosis is a narrowing of the spinal canal, nerve root canal or intervertebral foramina of the spine. Wow, what does all that mean? The brain sends information down to the body by way of the spinal cord. This structure is about the size of your little finger and extends all the way down your spine to a little above your waist. Actually it ends at the bottom of the thoracic spine, the rest of the spinal column contains individual nerves. If the hole that the spinal cord travels through gets smaller that is stenosis. If the hole that the nerves pass through in the lumbar or low back area gets smaller or if the hole that the nerves exit the spinal canal from gets narrower, that is also stenosis.
Imagine wrapping elastic around your finger. The tighter the elastic is, the more irritated your finger will be. The circulation gets cut off and your finger may swell and become painful. The same thing happens with stenosis. As the opening the nerves or cord pass through gets smaller, the little blood vessels associated with the nerve structures will get irritated and symptoms will occur.
The most common area of stenosis includes the L4/5 region of the lumbosacral spine. While no one is really sure what the cause is, some believe it is due to the blood vessel issue I described above while others think it is because of actual pinching of the nerve. The most common symptoms are sciatica, neurogenic claudication (pain, aching, cramping and tingling with walking relieved by sitting), leg fatigue, abnormal sensation in one or both lower extremities and fear of falling. These symptoms are increased during extension and are relieved with bending forward or again when seated.
Conservative care is appropriate for people with mild to moderate symptoms while surgery is reserved for patients with severe symptoms. You and your doctor would need to work together to decide which course of treatment is best for you. I will tell you that while I am an advocate for conservative care, I have observed spinal stenosis surgery and for the most part it is as mild a surgery as any surgery could be. But because there are always risks associated with surgery, unless there is a condition called Cauda Equina Syndrome (bowl or bladder incontinence) trying conservative treatment is always the first way to go.
While alternative treatment will not eliminate the arthritis or other cause of the narrowing, the goal of chiropractic care or what ever other type of care you choose is to decrease the symptoms and improve the quality of life of the patient. In my office we work on weight loss, exercise, orthotic arch supports, physiologic therapeutics and chiropractic adjustments to reduce any other irritation that might add to the problem. There are no guarantees that conservative care will work for you, but it is always less risky to take that approach before undergoing more invasive procedures.