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The word stenosis means a "narrowing" of some sort.  Now, that can refer to an artery or really any type of structure, but this post will deal with stenosis involving the spine.  Make sure to check out the links below for a good dose on the anatomy I'll be referring to.

Spinal stenosis is caused from pressure put on the spinal cord as it travels down your back.  This can be from a disc bulge or herniation, a slippage of one vertebra on top of the other (spondylolisthesis), or calcified deposits on the vertebrae.  Spinal stenosis can be in any area of your spine (cervical/neck, thoracic/upper back, lumbar/lower back), but by far the most we see is of the lumbar spine (low back).  The signs and symptoms of spinal stenosis can be misleading as you can have moderate to severe stenosis and little to no actual back pain.  Many people will have significant pain and or tingling/numbness in their involved extremities (arms for cervical and legs for lumbar).  Some will have no pain but will have significant muscle weakness and leg "giving way" episodes and others the opposite with no weakness but severe pain.  Symptoms can vary quite a bit depending on the area effected and how severe the stenosis is.  In serious cases bowel and bladder incontinence and impotence may occur.  And if this happens, you should see your doctor immediately.

Foraminal stenosis causes impingement on a spinal nerve as it exits the spinal cord.  This can be due to disc issues or deposits also, but generally effects a smaller area as only one spinal nerve may be involved.  The same signs and symptoms may occur as above, and the severity of symptoms may or may not be directly related to how severe the stenosis is.  Foraminal stenosis is generally easier to treat as only a specific nerve is effected and not (potentially) the whole spinal cord.

Most surgeons will want to attempt any and all conservative measures of treatment before considering surgery.  These include steroidal based injections, medications (usually of the anti-inflammatory variety), and of course physical therapy.  Therapy will focus on basic exercises and techniques to alleviate pressure if the condition is postural related.  Traction, or separation of the vertebrae, may be beneficial if the condition is disc related as it takes pressure off the discs and in turn takes pressure off the nerves effected.  In many cases, stenosis is made worse by overly tight muscles that only add extra pressure on the nerves.  In this case, stretching exercises, along with ice and or heat, and strengthening of other muscles may significantly reduce symptoms.  Exercise in a low impact setting, like aquatics, can work muscles while at the same time take pressure off the spine.  While not being able to change any already present structural changes, physical therapy can really make a difference.  We have worked with several people that have moderate and even severe stenosis, and have been able to not only avoid surgery, but get back to doing the things they enjoy.

I'll save the surgical options and it's rehab for another post, as that's a huge topic by itself.  Till then, check out the links below.

For way more than you ever wanted to know about spinal anatomy: 

Spinal stenosis fast facts via NIAMS, a government health site:  http://www.niams.nih.gov/Health_Info/Spinal_Stenosis/spinal_stenosis_ff.asp

Spinal stenosis info, from anatomy to treatment options (with pictures!):  http://en.wikipedia.org/wiki/Spinal_stenosis

For a little info on foraminal stenosis:  http://www.nervous-system-diseases.com/foraminal-stenosis.html
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