Spinal stenosis is a narrowing of the spinal canal and foramen, which results in “choking” of the spinal cord and/or nerve roots. Stenosis usually involves the narrowing of:
The spinal canal in the centre of the column of bones (spinal column) through which your spinal cord and nerve roots pass.
The spinal foramen openings between your spinal vertebrae through which nerves leave the spine and go to other parts of the body.
Spinal stenosis is most common in men and women over 50 years of age. It most often results from a gradual, degenerative ageing process of your spine. Degeneration of the spine occurs when the articular cartilage in the facet joints deteriorates and the discs between the vertebrae dehydrate. This narrows the space between the joint surfaces placing them under more stress, as a result the body lays down new bone at the margins of the joint. These boney spurs (osteophytes) fill the joint space and and can compromise the adjacent tunnels.
In lumbar spinal stenosis, the spinal nerve roots in the lower back are compressed and this can produce symptoms of pain, tingling, weakness or numbness that radiates from the low back and into the buttocks and legs, especially with activity. This is also known as a form of sciatica, however unlike patients who have sciatica due to a disc prolapse, the symptoms are relieved by sitting down in stenotic patients.
Stenosis patients generally find that sitting or bending forward relieves their symptoms. Because keeping the lower back ‘flexed’ relieves their symptoms, patients will often walk with a slight stoop forward or look downwards.
Treatment for for Osteoarthritis of the Spine
Physiotherapy treatment for patients with this condition is vital to hasten the healing process, ensure an optimal outcome and decrease the likelihood of injury recurrence. Treatment may comprise:
- Joint mobilisation
- Joint manipulation
- Spinal and pelvic realignment
- Dry needling /acupuncture
- Deep tissue massage/myofascial release
- Exercise programs to stretch, self treat and improve proprioception, balance, strength and core stability
- Biomechanical Assessment
- Neural mobilisation
- Education / training advise/ phased return to exercise
- Activity modification advice
- Orthotic/Insole advise
- Ice or heat treatment
- Clinical Pilates
- Injection advice