Spinal Stenosis With Arthritis

Spinal stenosis is a disease that affects many individuals, especially those who’ve reached or exceeded middle age. Simply stated, spinal stenosis occurs when the spinal column (which houses the spinal cord) becomes constricted. A number of factors can result in a narrowing of the spinal canal, chief among them the degenerative changes that occur as a person ages.

As we grow older, we all anticipate that our skin will become wrinkled, our hair will gray, and our eyesight will become less acute. Just as these degenerative changes can occur later in life, so too can changes that affect the spine. This area of the body isn’t only relied upon for protecting the spinal cord. This sends and receives sensory and motor signals to and from the brain, it is, however, also tasked with supporting the burden of the body and facilitating movement. Over time, these responsibilities can start to take their toll, causing part of the spine’s anatomical components to break down, such as facet joints, the vertebrae, and intervertebral discs.

The facet joints are responsible for connecting adjacent, articulating vertebrae. These joints afford us the capacity to bend, twist, and otherwise move our necks and backs. A thin layer of cartilage lines the joints and provides lubrication to prevent them from painfully grinding against one another. Over time, the joints’ cartilaginous lining can begin to wear away, leading to facet disease, or spinal arthritis. The body may produce smooth bony growths called bone spurs to stabilize an arthritic spine. These nodules can protrude into the spinal column, leading to neural compression.

Intervertebral discs, or the saucer-shaped ‘shock absorbers’ that separate articulating vertebrae, are made up of two parts: an outer shell called the annulus fibrosus, and an inner jelly-like filling called the nucleus pulposus. The annulus fibrosus isn’t only tasked with keeping the highly pressurized nucleus pulposus contained, but is likewise responsible for giving the discs their ability to ‘bounce back’ after weight and pressure are applied to them. The nucleus pulposus is relied on to verify that the pressure that is applicable to the disc is evenly dispersed in all directions. During the natural aging process, the annulus fibrosus can harden and lose elasticity, while the nucleus pulposus can lose water content. This degeneration can lead to herniated or bulging discs, each of whom are conditions that can directly lead to spinal stenosis. Herniated discs occur when the annulus fibrosus develops a crack or tear, allowing the annulus fibrosus to escape, then enter the spinal canal. Bulging discs, on the other hand, occur when the annulus fibrosus weakens to the extent that it can no longer contain the nucleus pulposus within its normal boundaries. This allows the disc’s inner contents it to shift and causes the disc to balloon to one side.

Regardless of which degenerative spinal condition is causing neural compression, most patients with spinal stenosis will experience similar symptoms. This typically includes pain, prickling, numbness, and muscle weakness that extends into the limbs. When neural compression occurs in the cervical spine, patients can experience symptoms in the neck, upper back, shoulders, and/or arms. A pinched nerve in the lumbar spine can cause discomfort in the lower back, hips, butt, and/or legs.

Most patients who’re diagnosed with spinal stenosis are in a position to relieve their symptoms through the use of conservative, nonsurgical treatments. This typically includes the use of medication, such as over-the-counter, nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, analgesics, or narcotic pain relievers. May patients also benefit from in collaboration with a physical therapist to build strength in the neck, back, and abdomen. Strengthened musculature can provide the spine with added support and can potentially help in relieving part of the pressure from the compressed spinal nerve. In addition to strength building exercises, physical therapy may also include transcutaneous electrical nerve stimulation (TENS), thermotherapy, posture modification exercises, and cryotherapy, among others.

Patients should consult their physicians before using alternative therapies, especially if they’re being used in addition to conservative treatments. This can prevent the development of harmful and potentially serious side effects and/or interactions.

Those who’re unable to relieve their spinal stenosis symptoms through the use of nonsurgical treatments may be advised to consider surgery. In the past, this often meant the patient would undergo open spine surgery that required the complete removal of one or several spinal component, a long incision, the dissection of muscles, and the installation of equipment and bone grafts to fuse some of the spine. Thanks to advances in medical technology, many patients who require surgical treatment for spinal stenosis can undergo a minimally invasive procedure in place of open spine surgery. These procedures are performed on an outpatient basis and utilize an endoscope to access the spine. Spinal components aren’t removed in their entirety. This means patients aren’t resigned to spinal fusion. Many patients recover within a few weeks. Some even experience immediate relief.

Patients should research all of the choices that are open to them before consenting to any form of surgical treatment. It may also prove beneficial to accommodate a second or third opinion to ensure surgical treatment is warranted. Those who wish to know more about spinal stenosis and the different treatments that are open to them should schedule an appointment with their primary care doctor or a specialist.

QUESTION: Which arthritis is associated with spinal stenosis?
I was told I have arthritis in my back and lower lumbar region going into spondylosis in my left hip. Today I got the diagnosis of spinal stenosis. Which arthritis is associated with it?

  • Any of the forms of arthritis can cause this. If you want more information on your new diagnoses, you can go to WebMd.com and type in the terms you have listed and read up on these conditions.