Spinal Stenosis

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Did you know that according to the Australian Institute of Health and Welfare that 1 in 6 Australians will have some sort of back issue in the last year? That’s more than a whopping 4 million people!

Spinal Stenosis is a back issue we see across our clinics and typically affects those of us over 50 years old. It occurs when the space around the spinal cord narrows. Whilst a lot of the time this narrowing doesn’t cause any symptoms and can be a normal age related change. In others it may crowd out the spinal cord or surrounding nerve roots that provide strength and sensation to the muscles and then cause an issue

What will I feel?

Spinal stenosis can cause back pain with or without any leg pain. This most often occurs when you are walking for a period of time. You may feel weakness or altered sensation in the back, buttocks, thighs, calf or feet and can occur in one or both legs.

These symptoms can even be more noticeable when walking downhill, standing, and walking for prolonged periods with an increase in leg pain or tiredness greater than what is in the back. 

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When this happens a lot of people will find relief by bending forwards or sitting in a slumped position for a period of time.

Clinically what are we looking for?

When a patient comes in our team will take a thorough history and examination and the main things we are looking for are: 

• Pain with spinal extension
• Pain with walking (due to exceeding vascular demands of already compressed tissue)
• Pain walking down hill
• Symptoms relieved with flexion
• Change of ranges of motion in the hips and spine
• Changes in the expected strength and endurance of muscles in the trunk, gluteals, and leg.
• Diminished lower limb reflexes, which may return after rest
• Weakness
• Pain or paresthesia in the lower back and lower limbs

Whilst we can not rely on imaging alone to confirm symptomatic spinal stenosis, MRI is very useful to visualise soft tissue and neural tissue - confirming any anatomical decrease in the central canal and/or abutment on the nerve.

How do we manage it:

The goal typically is going to be management not cure when it comes to Spinal Stenosis. Our recommendation is to co manage with your GP as there are conservative/exercise based solutions as well as pharmacotherapeutic solutions to help manage it. Here are a few of the recommendations we would advise: 

• Joint mobilisation, massage to manage any surrounding muscle spasm.
  

• Provide strengthening and stretching exercises.
  

• Management and discussion with your GP regarding anti-inflammatory medications.
  

• Weight loss to decrease further strain on the lower back.
  

•  Management with your GP or specialist regarding corticosteroid injection to assist with pain in conjunction with your strength program.
  

• Surgery may be indicated if desired outcome isn't reached with conservative care.

If this is something that sounds familiar to you please contact our team to schedule an appointment.