What you need to know
Refers to the narrowing of the spinal canal in which the spinal cord and nerve roots travel. It most often occurs due to degenerative changes in the spine as a result of aging and wear and tear. The discs which are the cushions between the bones start to collapse and decrease in height. The discs begin to bulge into the spinal canal, narrowing the area for spinal nerves. The bones begin to rub against one another and form bone spurs which further narrow the space for the nerves. It most often causes pain to shoot down the legs which is usually worsened by standing and walking. The location and side of the body affected is related to which nerve is being compressed. Patients also complain of decreased endurance during physical activities. Symptoms usually improve when sitting and leaning forward.
MRI is the most common way to diagnose the presence of nerve compression. CT scans may also be used in certain cases to make the diagnosis. As the stenosis worsens, whereby more pressure on the spinal nerves occurs from the bone spur formation getting bigger, the symptoms can include numbness, prickly feelings in the buttocks and legs, weakness, difficulty walking and bowel and bladder incontinence.
One can try a conservative route of treatment if no neurological symptoms exist such as nonsteroidals, physical therapy and lifestyle modifications. Severe flare ups can be treated with oral steroids and pain medications. If these modalities do not help then an epidural steroid injection can be considered to reduce swelling and inflammation. If pain symptoms persist or neurological symptoms develop, then surgery can be recommended.
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Patrick J. Horan, MD, MBA, FACS
Patrick J. Horan is an orthopaedic surgeon and sports medicine specialist with two decades of experience. He is board-certified in orthopaedic surgery and sports medicine. After receiving his undergraduate degree from Duke University in Durham, N.C., Dr. Horan earned his medical degree from Tufts University School of Medicine in Boston. Residency and Internship were both completed at Walter Reed Army Medical Center in Washington, D.C. He also received an MBA from Auburn University in Auburn, Ala.
Dr. Horan served 10 years on active duty in the US Army as an orthopaedic surgeon before entering into private practice. Dr. Horan is the founder of the Westchase Orthopaedic and Rehabilitation and the official surgeon of the Tampa Bay Rowdies. He maintains professional memberships with the American Academy of Orthopaedic Surgeons, the American Academy of Orthopaedic Sports Medicine and the Arthroscopy Association of North America.
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