Spinal stenosis is a condition that occurs when the spaces within the spine narrow, placing pressure on the spinal cord and nerves. This can cause pain, numbness, and weakness, as well as a wide range of other concerning symptoms (including nerve damage). Unfortunately, spinal stenosis is frequently misdiagnosed or overlooked, leading to delayed treatment, prolonged discomfort, and even irreversible nerve damage for patients. An orthopedic spine surgeon can help you learn the true nature of your condition, issue a proper diagnosis, and get you the treatment you need for relief.
Why is Spinal Stenosis Often Misdiagnosed?
Spinal stenosis symptoms can mimic other conditions, such as herniated discs, sciatica, or even circulation problems. Many patients experience vague symptoms like leg pain, headaches, or numbness and weakness in the hands, any of which can be mistaken for other causes. Common symptoms like incontinence and problems with coordination/dexterity, combined with the fact that most individuals with spinal stenosis are over the age of 50, often lead to the mistaken assumption that the problems are simply due to aging. Furthermore, symptoms often worsen gradually, making it very easy to attribute any discomfort to the natural aging process rather than an underlying spinal issue.
Symptoms of spinal stenosis can vary significantly based on the location and severity of the condition, making it especially difficult to diagnose. A thorough evaluation by an orthopedic spine specialist is essential for an accurate diagnosis and determination of treatment.
Recognizing Symptoms of Spinal Stenosis
Stenosis can occur anywhere along the spine. The two main types are cervical stenosis (in the neck) and lumbar stenosis (in the lower back).
Symptoms of cervical spinal stenosis can include:
- Pain, numbness, weakness, or tingling in the shoulders, arms, hands, fingers
- Problems with coordination, motor function, balance, reflexes, dexterity
- Pain may be dull or sharp
- Stiffness in the neck
- Headaches
- Often, minimal or no pain in the neck
- Incontinence
- Symptoms that go through cycles of remaining stable and flaring up
- Symptoms may worsen or alleviate during certain activities
- Cervical myelopathy (severe cases)
Symptoms of lumbar spinal stenosis can include:
- Pain (often severe) in the lower back, buttocks, and/or legs
- Tingling, weakness, numbness, or cramping in the legs
- Pain that inhibits daily activities
- Problems with balance and coordination
- Incontinence
- Symptoms that go through cycles of remaining stable and flaring up
- Symptoms may worsen or alleviate during certain activities or while sitting, lying down, and leaning forward
- “Shopping cart sign” (leaning over to alleviate intense pain)
How is Spinal Stenosis Diagnosed?
For a proper diagnosis of spinal stenosis, an orthopedic spine surgeon will conduct a comprehensive assessment involving the following:
- Medical History and Physical Exam: These identify symptoms, mobility limitations, and nerve-related issues.
- Imaging Tests: X-rays, MRIs, or CT scans help confirm the diagnosis by revealing spinal narrowing, bone spurs, or degenerative changes in the spine.
- Specialized Tests: Specialized tests such as nerve conduction studies may be used to differentiate spinal stenosis from other neurological conditions.
Getting Relief with Treatment for Spinal Stenosis
Once diagnosed, treatment for spinal stenosis depends on the severity of symptoms. Treatments can include:
- Physical Therapy (PT) to improve mobility and alleviate symptoms
- Anti-Inflammatory Medications to decrease inflammation and pain
- Spinal Injections for temporary pain relief
- Lifestyle Modifications such as weight/posture management and using a walker or cane to manage symptoms and improve mobility
- Surgical Options such as spinal decompression surgery, disc replacement surgery, or minimally invasive spinal fusion surgery may be necessary for severe or progressive cases
Treatment for spinal stenosis begins with a detailed assessment of how far the condition has progressed and the severity of symptoms. For patients diagnosed with lumbar stenosis, conservative (non-surgical) treatments will usually be recommended first; if conservative treatments are ineffective, symptoms are debilitating, and/or the degree of nerve compression is severe, surgery may then be advised. For patients diagnosed with cervical stenosis, conservative treatments may provide some symptom relief, but surgery is often the only effective treatment to prevent permanent nerve damage.
When to See a Specialist
If you are experiencing any of the above symptoms, and especially if you are experiencing several, don’t ignore them. Consulting an orthopedic spine surgeon will ensure that you receive an accurate diagnosis and a treatment plan designed to meet your needs.
At Orange Orthopedic Medical Group, our orthopedic surgeons are all board certified and specialize in an array of different orthopedic studies. To schedule your consultation, call (714) 538-8549 or contact us online today.