The Relationship Between Spinal Stenosis And Hip Pain
Although spinal stenosis often causes leg pain, some patients also experience spinal stenosis and hip pain. Hip pain is most commonly experienced by patients who have spinal stenosis in the lumbar section of the spine. Although it does happen, patients with spinal stenosis in the cervical or thoracic sections of the spine are less likely to experience hip pain as a symptom.
Spinal Stenosis Of The Neck And Arm
Spinal stenosis can typically be treated with non-surgical or minimally invasive surgical techniques.The word stenosis comes from a Greek word meaning narrowing. Stenosis in the spine refers to abnormal narrowing where nerves live, such as the spinal canal and foramen . When stenosis occurs in the neck, it can lead to compression of nerves causing pain, weakness, numbness and tingling.
Spinal Stenosis: Cervical Lumbar And Lumbosacral
The are many causes of back and neck pain, ranging from nerve damage to wearing the wrong pair of shoes. But sometimes this pain can indicate an underlying disorder called spinal stenosis, a condition that can develop when the spinal canal narrows and painfully compresses the spinal nerves.
Most people dont know they have spinal stenosis until they develop symptoms, says Andrew J. Schoenfeld, MD, an orthopaedic surgeon within the Department of Orthopaedic Surgery at Brigham and Womens Hospital. It usually starts with back pain, but it can progress to difficulty walking, loss of fine motor control and decreased bladder or bowel function.
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Does Cervical Stenosis Require Surgery
Cervical spinal stenosis does not require surgery unless it is severe and all other options have not been effective. It is recommended to try natural treatments before surgery.
Surgery helps reduce cervical spinal stenosis most of the time however, there are patients who report their symptoms have stayed the same or have worsened after their surgery. There is also risks of infection, blood clot, neurological deterioration, and a tear in the membrane that covers the spinal cord.
Because of the risks and uncertainty of symptoms being helped with surgery, we recommend natural treatments to be taken into consideration before such a big decision.
What Are The Parts Of The Spine
Your spine is a stack or column of 24 bones plus the fused bones of the sacrum and coccyx. It begins at the base of your skull and ends at your pelvis. Your spine supports your bodys weight and protects your spinal cord. Each vertebrae has a round front portion , a central ring-shaped opening , flat bony areas where one vertebrae comes into contact with others above and below it, and bone sections along the sides and back . Part of the lamina called the spinous process is the ridge you feel when you run your hand down your back. Between each vertebrae body is a flat, round pad called an intervertebral disk that serves as a cushion or shock absorber. Ligaments are strong fiber bands that hold the vertebrae together, keep the spine stable and protect the disks.
The spinal cord the bodys master cable cord that sends and receives messages between the body and the brain runs through the center of the spinal canal. It is completely surrounded by the bony parts of the spine. Nerves roots are the initial segment of a bundle of nerve fibers that come off the spinal cord and exit the spinal column through side spaces between the vertebrae called the neural foramen. The nerve fibers or nerves then go out to all parts of the body.
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Can Spinal Stenosis Cause Pain In My Groin Hip Thigh And Calf
Yes, this is certainly possible. If your spinal stenosis is pinching your sciatic nerve a nerve that originates in your lower spine you might feel pain or have numbness, tingling or muscle weakness along this nerves pathway from your lower back, down your leg to your foot. This condition is known as sciatica.
When Can Patients Expect Relief
Maximum relief is seen at six months, Dr. Young says. That isnt to say that patients wont experience relief earlier. Patients will have improvements in their back pain and their leg pain and that benefit has been maintained for about two years. Beyond two years, we still have improvements in both the back and legs. I know a lot of folks who have very realistic expectations because theyve had pain for a long time. If you can reduce their pain by 70 percent, if you can make that big of a dent in their pain, it can make a huge improvement in their quality of life.
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What Are The Treatments For Spinal Stenosis
Choice of stenosis treatments depend on what is causing your symptoms, the location of the problem and the severity of your symptoms. If your symptoms are mild, your healthcare provider may recommend some self-care remedies first. If these dont work and as symptoms worsen, your provider may recommend physical therapy, medication and finally surgery.
Self-help remedies include:
- Apply heat: Heat usually is the better choice for pain due to osteoarthritis. Heat increases blood flow, which relaxes muscles and relieves aching joints. Be careful when using heat dont set the settings too high so you dont get burned.
- Apply cold: If heat isnt easing your symptoms, try ice . Typically ice is applied 20 minutes on and 20 minutes off. Ice reduces swelling, tenderness and inflammation.
- Exercise: Check with your healthcare provider first, but exercise is helpful in relieving pain, strengthening muscles to support your spine and improving your flexibility and balance.
Non-surgical treatments include:
Steroid Injections For Spinal Stenosis
Dr. Young can reduce or eliminate inflammation and pain with steroid injections.
An epidural injection is the most common approach, he says. Injecting steroids in those areas of the spine can lead to some relief.
If there is an anatomical problem such as a bulging disc present, or overgrown joints in the back, advanced procedures are required.
Injections are the first line option for these things and then when it comes to next steps, we start to discuss the MILD procedure, Dr. Young says.
All of my injections that I typically perform are under image-guidance. It helps me to be quite precise in where those injections are actually delivered.
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Can Spinal Stenosis Be Reversed Can Spinal Stenosis Get Better
No, spinal stenosis cant be reversed but the process might be able to be slowed if you take good care of yourself by maintaining a healthy weight, eating healthy foods, exercising regularly to keep your bones and muscles strong, and following your healthcare providers instructions to best manage any existing medical conditions you may have. If you do develop symptoms, there are many options up to and including surgery that can be considered to relieve your pain and other symptoms so you feel better.
Stenosis In The Cervical Spine Can Affect Both The:
- Spinal nerves causing arm pain
- Spinal cord resulting in imbalance and coordination difficulty
If spinal nerves are being strongly pinched, a radiculopathy may occur and the patient can experience constant arm pain, as well as numbness and weakness. When the intervertebral foraminae are reduced in size due to surrounding build up of tissue, the nerves react to the pressure by swelling. This causes further pressure on and irritation of the nerves. Compression of the nerves is generally worse when the patient extends the neck , and this usually increases the amount of arm pain.
Spinal cord compression may result in a myelopathy. This is an irreversible weakness and loss of muscle bulk of the muscles of the arms, hands and sometimes legs. Balance and coordination problems, as well as bowel and bladder incontinence may develop.
The symptoms of cervical spinal stenosis may be very mild or even absent even when significant stenosis is present. This is because the spinal cord has the capacity to accommodate to some extent. However, a sudden or severe force such as a car accident or fall can result in severe symptoms in a patient with pre-existing cervical stenosis. The medical term for one such syndrome is central cord syndrome.
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Is Spinal Stenosis Causing Your Chronic Back Pain
Back pain is one of the most common reasons for calling in sick to work, and it accounts for more than 264 million lost work days every year thats two full work days for everyone in the country who works full-time. If you are one of the millions of Americans suffering from chronic back pain, youre probably searching for a long-term solution.
If youre experiencing chronic back pain and you live or work in the Washington, DC, or Arlington, Virginia, areas, the highly experienced orthopedic team at International Spine, Pain & Performance Center can help. We diagnose the underlying cause of your back pain, which could be spinal stenosis a common cause of back pain, especially as you get older.
Improve Your Spinal Health With The Spine And Rehab Group Ny
Spinal stenosis is a manageable condition, but you may experience chronic fatigue because of its overall effects. Most times, adjustments to your lifestyle can be enough to treat fatigue. However, a certain amount of tiredness is to be expected, especially if youre an older patient.
With the Spine And Rehab Group, you can get a fast diagnosis and effective treatment of your back pain, and manage the underlying condition to prevent it from getting worse. We pride ourselves on offering innovative and quality treatments combined with excellent customer service. As one of New Yorks leading providers on spinal care, you can visit any of our clinics in the city today for a consultation about us and what we can do for you.
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Spinal Stenosis Diagnosis And Tests
The doctor will ask questions about your medical history. After that, they might order at least one of the following tests to figure out whether you have the condition:
- Medical history review. Your doctor will ask about your health history and risk factors.
- X-rays. These can show how the shape of your vertebrae has changed.
- Magnetic resonance imaging . By using radio waves, an MRI creates a 3-D image of your spine. It can show tumors, growths, and even damage to discs and ligaments.
- Computerized tomography . A CT scan uses X-rays to create a 3-D image. With the help of a dye injected into your body, it can show damage to soft tissue as well as issues with your bones.
When To Call Your Doctor
Pain tolerance can vary significantly from patient to patient. Low back pain that is tolerable for one patient may drive another one to the emergency room. You should consider seeing your doctor if you have:
- Low back pain is persistent and not responsive to conservative care
- Persistent leg numbness and tingling
- Fever and chills
- Loss of bowel or bladder function
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What Are Interspinous Spacers
Interspinous spacers are a newer technology and offer an option for individuals who have spinal stenosis without evidence of ligamentum flavum thickening, Dr. Young says. They can be implanted under twilight anesthesia, utilizing a very small incision, and followed by a short recovery phase of two weeks. After that time, patients are encouraged to return to their regular activities.
The difference between spacers and the MILD procedure is that youre propping open the spine, like a jack, to keep the space open.
The spacers are made of titanium and the procedure itself is considered outpatient surgery. My patients will need to avoid bending at the waist, twisting at the waist, and avoid lifting over 10 pounds for two weeks to allow the device to settle and scar into place, Dr. Young says.
What Are The Symptoms Of Stenosis Of The Neck
Cervical stenosis or stenosis of the neck may remain asymptomatic or sometimes produce discomfort and pain in the neck. When symptoms are noted, there may be pain in the neck, difficulty in movement of the neck with a feeling of stiffness in the neck joint area.
Sometimes stenosis of the neck with radiculopathy is noted with pain, numbness or tingling extending to the arms, hands and fingers. It results from a nerve root being pinched in the narrowed spinal canal. It can also present with difficulty in using hands for coordinated movements or fine motor skills like buttoning, holding objects, etc. Weakness and difficulty in movement of limbs can occur. Difficulty in balance and co-ordination, dizziness, vertigo and headaches may be noted.
In severe stenosis of neck, where the spinal cord gets compressed, loss of bowel and bladder control can be seen. Stenosis of the neck with myelopathy, can affect both hands and legs. Like hands, there may be pain, numbness and weakness in legs with difficulty in walking. Inability to assess the sense of position, difficulty in sensing the position and movements of hands, legs may be seen.
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Cervical Spinal Stenosis Symptoms
Spinal stenosis in your neck can cause cervical radiculopathysymptoms may include pain accompanied by tingling sensations, numbness and/or weakness. These symptoms may radiate downward from your neck into one or both shoulders, arms and/or hands. The pain caused by cervical spinal stenosis may be described as acute, episodic, occasional, or it may become chronic its intensity can vary from mild to severe.
Other symptoms may include:
Symptoms Associated With Spinal Stenosis
The symptoms caused by spinal stenosis depend on the nerves affected but at minimum typically include neck or back pain. The nerves exiting from the neck control the muscles of the arms and neck and carry the sensations of feeling, such as touch, hot, cold and pain. The nerves exiting from the middle part of the back control the abdomen and chest and supply them with sensation. The nerves from the lower back are in control of the muscles for the legs and buttocks and carry the sensations of feeling in the lower part of the body. When these nerves are compressed, the person feels numbness, pain and tingling in the affected part of the body.
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How Is Spinal Stenosis Diagnosed
Your healthcare provider will review your medical history, ask about your symptoms and conduct a physical exam. During your physical exam, your healthcare provider may feel your spine, pressing on different area to see if this causes pain. Your provider will likely ask you to bend in different directions to see if different spine positions bring on pain or other symptoms. Your provider will check your balance, watch how you move and walk and check your arm and leg strength.
You will have imaging tests to examine your spine and determine the exact location, type and extent of the problem. Imaging studies may include:
- X-rays: X-rays use a small amount of radiation and can show changes in bone structure, such as loss of disk height and development of bone spurs that are narrowing the space in the spine.
- MRI: Magnetic resonance imaging uses radio waves and a powerful magnet to create cross-sectional images of the spine. MRI images provide detailed images of the nerves, disks, spinal cord and presence of any tumors.
- CT or CT myelogram: A computed tomography scan is a combination of X-rays that creates cross-sectional images of the spine. A CT myelogram adds a contrast dye to more clearly see the spinal cord and nerves.
A Narrowing Spinal Canal Often Comes With Age
As you get older, its not uncommon for your spinal canal to narrow as a result of wear-and-tear and other conditions associated with aging and back pain. This narrowing of the spinal canal is called spinal stenosis.
Your lower spine is made up of five large vertebrae stacked on top of each other. Each of the vertebra contains a large, bony disc and two facet joints. The facet joints connect your vertebrae and make your spine flexible so you can move easily.
Your vertebrae also protect your spinal cord, which runs through a canal in the center of the stacked vertebrae. Over time, the canal may narrow as a result of arthritis or other degenerative conditions. As a result, your spinal cord no longer has as much space as it once did.
When you have spinal stenosis, the narrower spinal canal puts pressure on your spinal cord and also on the spinal nerve roots. As a result, you end up with lower back pain or neck pain and symptoms, including:
- Back pain that gets better when you lean forward or sit
- Numbness or cramping in your buttocks or legs
- Foot slapping the ground while walking
- Problems with balance
- Weakness in your arms or legs
- Tingling feeling in your hands, arms, or feet
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Diagnosis For Cervical Stenosis
Cervical stenosis is usually diagnosed through a series of appointments, during which your doctor will go over your medical history, conduct a physical exam, and order or conduct one or more tests.
An MRI or CT scan typically confirms the diagnosis. Dye is injected into your spine prior to these tests.
How Is Lumbar Spinal Stenosis Treated
If you have lumbar spinal stenosis, many types of healthcare professionals can help you, such as arthritis specialists, nerve specialists, surgeons, and physical therapists. Treatment can include physical therapy, medicine, and sometimes surgery. Except in emergencies, such as cauda equina syndrome, surgery is usually the last resort.
- Physical therapy may include exercises to strengthen your back, stomach, and leg muscles. Learning how to do activities safely, using braces to support your back, stretching, and massage may also be helpful.
- Medicines may include nonsteroidal, anti-inflammatory medicines that relieve pain and swelling, and steroid injections that reduce swelling.
- Surgical treatments include removing bone spurs and widening the space between vertebrae. The lower back may also be stabilized by fusing together some of the vertebrae.
- Acupuncture and chiropractic care may also be helpful for some people.
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