Posts Tagged ‘cervical stenosis, arm pain & numbness’
Spinal stenosis can be a pain in the neck, literally! This condition is the result of a gradual narrowing of the spinal canal, which may place pressure on the spinal cord or nerves. This most commonly affects the lumbar (low back) and cervical (neck) areas of the spine. The most common cause of spinal stenosis is aging. The rate of progression of the disease varies as people age and the changes are often quite gradual.
The symptoms of spinal stenosis depend on where the narrowing is. Most spinal stenosis affects the lumbar, or lower back, area. You experience pain radiating down your leg that is relieved if you sit or bend forward. In severe cases, you could lose bowel, bladder or sexual function and have difficulty walking.
The second most common area for spinal stenosis to occur is in your neck, or cervical spine. People with cervical stenosis may feel pain radiating down an arm, or aching, numbness or tingling in the arm or leg. They may have difficulty with fine motor skills, such as picking things up with their fingers or writing, problems walking or loss of bladder and bowel control.
Cervical spinal stenosis occurs in the neck and can involve either the cord or spinal nerves. If spinal nerves are involved, you will have pain, numbness, tingling and/or weakness of the neck, shoulders and/or arms. If the cord is involved, you may also have symptoms affecting your legs, usually uncoordinated movement and difficulty walking.
Thoracic stenosis is rare because there is less curvature in the thoracic spine, and therefore less stress on the joints between vertebrae. The spinal canal is normally narrower in the thoracic spine, however, so it takes less obstruction to cause symptoms.
Lumbar stenosis is common, and involves the lower back. Lumbar stenosis causes pain in the lower back and leg and may also cause weakness in one or both legs.
Diagnosing Spinal Stenosis
• Complete history to determine how long symptoms have been present and if condition is worsening
• Physical Exam to evaluate pain and weakness of extremities
• Neurological exam will identify chronic nerve root depression
• Laboratory tests to rule out unusual causes of nerve root and spinal cord dysfunction
• X-rays of lumbar and cervical spine can identify the amount of spinal degeneration or instability.
• A CAT scan (Computerized axial tomography) helps visualize the spinal column and identifies areas of stenosis.
• A myelogram, in which a dye is injected into the space occupied by the spinal cord and nerve roots, can identify problem areas.
• An EMG (electromyographic) test helps identify compressed nerve roots.
Conservative methods of treatment are used as long as possible. They don’t cure the problem, but most people get relief of their symptoms for quite a while by doing prescribed exercises, including flexion. Most people have good results with physical therapy. Chiropractic, massage and acupuncture often help, too.
Most doctors prescribe muscle relaxers or anti-inflammatory medications to relieve the symptoms of spinal stenosis. If those don’t work, epidural cortisone treatments and nerve blocks may be helpful.