Conditions of the Spine

When narrowing places pressure on the spinal cord or nerve roots, there may be a slow onset and progression of symptoms. You may feel pain and difficulty when walking aggravated by activity, numbness, tingling, hot or cold feelings, weakness, or a heavy and tired feeling in the legs. People with more severe stenosis may experience abnormal bowel and bladder function as well as foot disorders.

X-rays show the bony spurs and narrowing of the inside of the canal. However, x-rays do not show nerve problems or the internal structure of the spinal cord.

CT scans and MRI scans are used to reveal the relationship between nerves and the bony structure of the spine. If nerve damage or nerve irritation is suspected, EMG (Electromyo-graphy) and nerve conduction studies are very helpful. Information from these tests help to locate the specific vertebrae and spinal nerves involved, allowing a diagnosis and an appropriate treatment program.

Anti-inflammatory medicines, taken by mouth, are the first line of treatment. If symptoms persist, a more specific and potent anti-inflammatory medication (a cortisone type drug) can be injected into the site of irritation. This is done by a procedure called Epidural Steroid Injection (ESI). People with spinal stenosis may also find changing their posture can offer some relief of pain. Flexing the spine by leaning forward while walking may make it easier for stenosis sufferers to walk longer distances. Losing weight can also help relieve some of the load on the spine.

Relieving the pain is the first step. The main goal of physical therapy however, is to keep the problem from returning. Special exercises are taught to place the back in positions which give the most room in the spinal canal, and to avoid positions which make the canal narrow. If the muscles are tight and weak, aquatic exercise may first be necessary so that posture exercises will be effective. Exercising in water reduces the effect of gravity and allows you to move freely. A program of individually tailored exercises can be developed for use at home.

When symptoms return repeatedly because of severe pressure on the nerves, surgery to relieve the pressure on the affected nerves or spinal cord may be recommended. Removal of the obstruction that has caused the symptoms usually gives patients some relief. Many patients have less leg pain and are able to walk better following surgery.

Your doctor may order one or more special tests to help confirm your diagnosis, rule out other problems and pinpoint the source of your spine pain.

-X-rays show the general condition of your vertebrae (bones) and are very helpful in determining the cause of pain. Although x-rays cannot reveal a ruptured disc, they may reveal a narrowed disc space which can be an indication of trouble in that area of the spine.
-MRIs (Magnetic Resonance Imaging) and CTs (Computerized Tomography) produce detailed computer images of soft tissues and bones. MRIs are especially beneficial for the study of soft tissue abnormalities such as disc degeneration, protrusion or rupture. CT scans give a cross-section view of the spine and can show a bulging or ruptured disc.
-EMGs (Electromyography) measure the electrical activity of your muscles’ contractions. They detect nerve or muscle irritation and damage.
-Bone scans can reveal abnormal bone activity.