By Dr. Rick Morris
Helen, a 65 year-old nurse with a mild history of low back pain was worried. She had always been very active, not only at work, but playing tennis and walking three miles twice per week. She prided herself on looking ten years younger than her age and believed her health was a testament to her lifestyle and positive attitude.
But, in the last year or so, her legs began to ache. She massaged them and slowly began to modify her activities. She looked for the things in her life that must have “brought it on.” Eventually, numbness started showing up in her legs and feet.
Her doctor ordered an MRI and told her she had Spinal Stenosis. Despite her medical background, she didn’t really know what it was. The doctor explained that her spinal canal was getting smaller and compressed the nerves to her legs. He recommended physical therapy and possibly spinal injections, but they didn’t help much. Surgery was an option, but he advised against it. He said the risks didn’t outweigh the benefits.
At first, she tried living with it, and then her life started getting smaller. Shopping trips were no longer fun, cleaning the house was a struggle, her daily exercise was stopping and she was getting depressed—seriously depressed. She couldn’t believe this was the way she was going to spend the rest of her life.
Helen is a typical patient we see in our clinic with spinal stenosis. They usually come in with a diagnosis, have tried a few treatments which, at best, helped temporarily and watch as the quality of their life slips away. They arrive at our office because they’ve heard about our treatment for spinal stenosis and they seriously hope it will help them. But first…
WHAT IS SPINAL STENOSIS?
Spinal stenosis is a narrowing of the spinal canal. That’s the long vertical space, encased by your vertebrae, that protects the spinal cord (see the pictures below).
The size of your spinal canal is genetically determined, but it can be narrowed by the effects of gravity such as arthritis, spinal misalignment, disc herniations, etc.... That’s why spinal stenosis is more common as we age. A small canal limits the room for the nerves and spinal cord causing low back and leg pain, especially when standing and walking. Sitting and curling up in a ball temporarily enlarge the canal and relieve the pain.
What Causes Spinal Stenosis?
As we mentioned, aging can narrow the spinal canal due to the following reasons (see the pictures below):
- Our spinal curves increase as we age due to gravity, misalignment, bad posture and poor muscular support. In other words, a curved spine compresses the spinal canal and a straight spine opens it up.
- The narrowing, herniation or bulging of the spinal discs into the spinal canal.
- The ligament within the spinal canal, called the Ligamentum Flavum, thickening and “hogging-up” all the room.
- Arthritis of the spinal facets bulging into the spinal canal.
- Scar tissue from prior spinal surgeries or injuries invading the spinal canal.
What Are The Signs of Spinal Stenosis?
Spinal stenosis is commonly seen in the last three levels of the lumbar spine (i.e. L3—S1). Even though a spinal stenosis may be seen on an MRI, Myelogram or even X-ray, its diagnosis as the cause of your pain can only be made from a thorough Spinal Stenosis Examination. Just because you have a narrow canal does not mean it’s causing your back or leg pain! Many canals are quite small, yet produce few symptoms.
The most common symptom of spinal stenosis is spinal claudication. It’s a name we use to describe leg pain that increases with walking and is relieved by sitting and resting. It often occurs down both legs (although one leg is usually worse) and is often associated with numbness, burning and leg weakness. The symptoms can be anywhere from your buttocks to your feet.
Most patients complain they can walk a few blocks or less, but have to stop due to leg pain. Usually the achiness or burning goes away by bending or bringing the legs up into the chest (while lying down). But it comes back after resuming the walk. The stenosis may become so severe that the leg pain becomes constant and unremitting, making walking nearly impossible. The disability on ones life cannot be overstated both mentally and physically!!!
Couldn’t My Leg Pain Be Caused By Something Other Than Spinal Stenosis?
Of course it can. These are a few of the conditions that must be distinguished from Spinal Stenosis:
- Herniated disc without spinal stenosis.
- Disc tear and leaky disc syndrome.
- Spondylolisthesis or Spondylolysis.
- Sciatica and Piriformis Syndrome.
- Compressed Spinal Nerves (outside of the spinal canal).
These conditions all have different treatments. Many of our patients had been misdiagnosed originally and weren’t returned to their healthy lives until the correct diagnosis and treatment plans began. My greatest joy in practice is returning patient’s lives back from pain and disability to one that’s free and active. In other words, giving them their lives back.
What Are My Treatment Options?
Patients are often told there are no good treatments for spinal stenosis. THIS IS NOT USUALLY TRUE. Yes it is difficult to treat, but our patients will tell you that proper treatment has given their lives back to them.
Surgery is rarely an option since it may produce scar tissue which can further narrow the spinal canal. Also, the surgery that enlarges the spinal canal is often quite invasive and has poor outcomes.
Anti-inflammatory medications may temporarily help the symptoms, but as the canal narrows, the condition worsens.
Physical therapy modalities such as heat, ultrasound and electric stimulation are usually only mildly helpful. Exercises are essential and must be performed in an exact way so that the canal is stabilized and enlarged, not compressed. Often patients are prescribed exercises that do as much harm as good.
Chiropractic manipulation can be helpful if performed properly. The spinal alignment must be optimized to expand the spinal canal. The doctor must be careful to avoid certain techniques which can worsen the condition.
What’s The Best Treatment for Spinal Stenosis?
The Santa Monica Non-Surgical Disc Center has designed a protocol which is taught to health care providers all over the country. It’s very thorough, safe and comprehensive. It utilizes non-surgical spinal decompression as well as methods from physical therapy, chiropractic, anesthesia and rehabilitation. If your spinal stenosis fits our treatment guidelines, our outcomes are exceptional. Patients often double and triple their walking and standing abilities within two months!! Their use of medication is often cut in half.
What’s Your Treatment Plan?
Our approach is an intensive two-month protocol. It combines all traditional and non-traditional approaches that open the spinal canal including the Non-Surgical Spinal Decompression from DRX 9000. As mentioned previously, spinal alignment, physical therapy, rehabilitation, anesthesia and many other modalities are used as well. This is not just a standard DRX Spinal Decompression Program. It is a treatment system designed specifically for Spinal Stenosis. It allows us to:
- Lengthen the Spine and Decrease Spinal Curvatures
- Reduce Disc Herniations
- Reduce Spinal Adhesions and Scar Tissue
- And, Enlarge The Spinal Canal
The approaches and modalities we use have been studied and shown to reduce disc herniations, break-up adhesions and stretch and lengthen the spine. In practice, we see its effects on spinal stenosis’ pain and disability every day.
If you are suffering from Spinal Stenosis or if you know anyone who is, please have them call our office today at (310) 451-5851. Bring in all images and x-rays. The exam and report of findings require two appointments totaling about two hours. It will be the most comprehensive exam and report of findings you’ve ever had, and is essential in finding the cause of your stenosis and whether our non-surgical approach will help.
If you believe you have spinal stenosis, don’t give up and settle for surgery, more injections and disability. It doesn’t just stay the same; it usually gets worse with age. The longer you have it, the more damage occurs to the nerves and the lower the expected results.