Spinal Stenosis: Relief Without Surgery
by Eric Winder, DC
Harry is a patient of mine with spinal stenosis in his lower back. When he first came to me, Harry couldn’t bear to stand or walk more than five minutes without sitting down and resting due to the pain. Today, he can walk for a mile or cook in the kitchen for 30 minutes or more without needing to rest. In this article, we will explore the nature of this condition, and how Harry found relief without invasive surgery.
Spinal stenosis is the name for a narrowing of the spinal canal or the holes where nerve roots leave the spine. This can potentially pinch or rub the spinal cord and spinal nerves. It can happen anywhere in the spine but most commonly occurs in the neck and lower back. In both areas, the symptoms can have a huge impact on quality of life.
In lower back (or lumbar) stenosis, there is often pain only when standing or walking, and relief tends to come from bending slightly forward. People with this problem often walk bent forward at the hips and might experience relief simply by leaning on a shopping cart. Some people with lumbar stenosis develop neurogenic claudication which can include weakness, numbness, pain and tingling in the thighs or lower legs when walking. Typically, the symptoms will become worse the longer those people are on their feet.
The immediate cause of spinal canal narrowing is a degenerative change in the spine. This can be due to bulging or herniated discs, bone enlargement or spurs, and thickened ligaments. In some cases, there is also a slippage of alignment of one vertebra on another, shrinking the space for nerves to travel through. In more severe cases, the above problems contribute to nerve impingement. Also, in some cases, people are born with an unusually narrow spinal canal.
Harry has many of the above issues including severe spinal canal stenosis at two points due to disk bulges, thickened ligaments, bone spurs and slippage of a vertebra. His pain was slightly worse on the right side, and he complained of poor balance.
His treatment at our clinic consisted mainly of fascia release (soft tissue therapies), specialized stretching of the lower back and home exercises. If we took another MRI of Harry’s spine today, the stenosis would not look visibly different. And yet, he feels much better, and is able to accomplish more than he could before treatment. This leads to the question: How can a non-invasive treatment relieve the pain?
The answer is that spinal degeneration typically starts with weakness and instability in the lower back and spinal joints. Restrictions in the connective tissue (or fascia) from past injuries or postural stress are among the main causes of this problem, so treating restricted fascia can help slow down or even stop the degenerative change. This helps the spine to function better, and reduces the pain triggered by the narrowing of the nerve passages.
Harry is only one of hundreds of patients who I have treated with spinal stenosis pain. This complaint responds well, in most cases, to non-invasive therapies. Every year, I refer one or two patients for surgical consult because it is the most appropriate care for their situation. However, typically spinal stenosis patients at our office have significant improvement in their pain and quality of life, and in particular, the amount of time they can be on their feet.
It is interesting that research shows the severity of the stenosis on MRI has little correlation with the severity of symptoms. I find that is true in the patients I see also, and that even severe cases can respond well to our conservative treatment methods.
Dr. Eric Winder has been practicing chiropractic for 21 years with a focus on fascia treatment and soft tissue therapies for the past 18 years. Dr. Winder’s practice focuses on relieving pain and restoring alignment and motion through soft tissue therapies without forceful manipulation. For more information, call 941-957-8390 or visit GentleBay.com.