Senior Citizen's Guide digital books
Senior Citizen's Guide to Southwest Ohio

Spinal Stenosis
Aging Disease of the Spine

Spinal stenosis is one of the most common disorders of the aging spine. It is related to the development of arthritis in the spine. We see degenerative changes occurring in the disks of the lumbar spine. When this occurs, the disk collapses and so do the facet joints in the back of the spine. When the disks and facet joints collapse the ligaments become very loose and sloppy. The body develops spurs in an attempt to tighten these ligaments of the disk and facets. These spurs tend to develop in the spinal canal, creating a narrowing. When most of us were younger we had galvanized pipe in our houses. When rust built in the pipes, the water would not flow and the plumber would have to come and replace the pipe. Spinal stenosis is like having rust (spurs) building up in the spine.

The primary symptom that people get with spinal stenosis is claudication in the legs. Claudication is cramping in the calves with walking. There are two different types of claudication – vascular claudication and neuro claudication. The difference between the two is that vascular claudication is the same every time. When you walk and the cramping starts at 200 feet, it will start at 200 feet every time. Neuro claudication is very inconsistent. You may be able to walk 200 feet this time but 50 feet the next. Also, people with stenosis tend to lean forward when they sit down. This unconscious effort opens up the spinal canal and gives a person relief.

In the later stages of stenosis, the pain in the legs becomes more constant. It can be present at rest as well as with walking. People find they cannot walk from one end of the house to the other without resting. At the end stage of this degenerative disease, weakness and numbness develop. When that happens, whatever is lost cannot be recovered.

During the early stages of this disease state, steroid epidural blocks can give tremendous relief of pain for months and even years. At the end stage, spinal decompressive surgery is the only answer. When people have severe lung or heart disease and cannot undergo surgery, a dorsal column spinal cord stimulator can give relief of pain but cannot restore the muscle strength or the numbness.

Editorial provided by Stephen Pledger, M.D. from Pledger Orthopaedic and Spine Center.

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