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Integrative Solutions for Spinal Stenosis Well-Being

Spinal stenosis is a disorder in which the spinal canal narrows, leading to back pain and leg pain that comes and goes with activities such as walking. Although stenosis can occur in all areas of the spine, it most commonly affects the lumbar (lower) spine. However when spinal stenosis occurs in the back, it produces pressure on the spinal cord and may affect gait, bowel and bladder function. Thus spinal stenosis almost always requires spinal treatment. Since it most commonly results from a combination of aging and degeneration of the spine, stenosis usually affects people over 60 years of age. However, the disorder also occurs in younger people who have abnormally small spinal canals from birth.


Since spinal stenosis gives the spinal cord and nerves less room to move, they can become irritated and inflamed. Stenosis in the lower back can cause pain in both the back and legs, with the pain becoming worse when walking or standing for a prolonged period of time. Rest, which takes pressure off the nerve roots, may ease or even eliminate these symptoms.

Potential Causes

Anything that narrows the spinal canal makes the spinal cord and spinal nerves vulnerable to pressure that may cause irritation and inflammation. Conditions that can narrow the spinal canal include wear and tear of the joints (degeneration), bulging or herniated discs, arthritis, swollen ligaments, facet joint enlargement (hypertrophy), bone spurs and spondylolisthesis. Rarely, spinal infection or tumors may mimic the symptoms of spinal stenosis. Any activities that increase the demand for blood flow cause the blood vessels to swell and enlarge.

If the spinal canal has narrowed, it may leave little or no room for the blood vessels to enlarge. This makes it difficult for blood flow to increase, which causes pain. Weakness also results because the nerves cannot get enough oxygen (which is carried through the bloodstream) to meet the demand. People who have a narrow spinal canal from birth are at risk for developing stenosis earlier in life because even minor crowding inside the spinal canal can cause pain.


The most common diagnostic tests used to determine the presence of spinal stenosis are X-rays of the lower back and an MRI. In some cases, a CT scan may be ordered, either in addition to an MRI or instead of one.

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Treatment Options

Conservative Treatment

Spinal stenosis is a slowly progressive back problem that in its early stages may respond to conservative care, such as pain medications and rest.

Your doctor may also recommend physical therapy and/or an epidural steroid injection (ESI).

In some cases, simply bending over can relieve the back and leg pain caused by spinal stenosis, because bending over enlarges the spinal canal so that the blood flow to the spinal nerves increases.

Surgical Treatment

Spinal stenosis may worsen over time, necessitating surgery. The main goal of any surgical procedure is to remove the pressure on the nerve roots in the lumbar spinal canal. The surgeon will therefore enlarge the tube of the spinal canal and remove any bone spurs that are pushing into the nerve roots. This procedure is called a decompression, or a decompressive laminectomy, of the lumbar spine. The surgeon may also have to remove a portion of the facet joints. The lamina and facet joints normally provide stability in the spine. Removal of either or both can cause the spine to become loose and unstable. If this occurs, doctors will restabilize the spine by including spinal fusion as part of the procedure. In most cases, surgery to correct spinal stenosis is appropriate only when the patient regards the pain as unbearable.

In the cervical spine, stenosis may sometimes require decompression from the front, back or both front and back of the spine depending on the severity of the stenosis.

Spinal Stenosis Specialist

Your chance of developing spinal stenosis increases over the years as wear-and-tear takes a toll on your spine and causes degenerative disease. As spine specialists, Steve Paragioudakis, MD, and Marc Menkowitz, MD, at the Center for the Functional Restoration of the Spine, offer comprehensive care for spinal stenosis. They provide the full range of treatment, beginning with conservative therapies and performing minimally invasive procedures when needed to relieve your pain and restore mobility. For help with your back or neck pain, call one of the offices in Shrewsbury, Toms River, and Edison, New Jersey, or schedule an appointment online today.

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Spinal Stenosis Q & A

What causes spinal stenosis?

What symptoms does spinal stenosis cause?

How do specialists diagnose spinal stenosis?

How do specialists treat spinal stenosis?

What causes spinal stenosis?

Spinal stenosis occurs when the area inside the spinal canal narrows. Though spinal stenosis can develop after a spinal injury, you’re more likely to have the problem due to degenerative conditions like:

  • Herniated discs
  • Facet joint arthritis
  • Degenerative disc disease
  • Vertebral bone spurs
  • Thickened spinal ligaments
  • Slipped vertebrae

A slipped vertebra affects the spinal canal by misaligning the spine. The other underlying conditions lead to spinal stenosis as they protrude into the spinal canal.

What symptoms does spinal stenosis cause?

Spinal stenosis causes back pain in the affected area. In many cases, spinal stenosis also compresses the nerves, causing symptoms that travel down your arms and legs. You may experience symptoms such as:

  • Pain in your neck or lower back
  • Pain that radiates down your arms or legs
  • Tingling or numbness in your arms or legs
  • Weakness or tiredness in your arms or legs
  • Leg cramping
  • Hand weakness
  • Difficulty walking

Though spinal stenosis can affect any part of your spine, it most often occurs in your lower back or lumbar spine.

How do specialists diagnose spinal stenosis?

In addition to a physical examination and reviewing your symptoms, your provider at the Center for the Functional Restoration of the Spine uses diagnostic imaging. The most common imaging tests used to verify the presence of spinal stenosis include X-rays and an MRI. In some cases, you may also need a CT scan.

How do specialists treat spinal stenosis?

The team at the Center for the Functional Restoration of the Spine begins with conservative therapies. Your conservative treatment plan may include pain medications, physical therapy, and activity modification. When you need more pain relief than you get with oral medications, your provider may give you an epidural steroid injection. This injection precisely targets the affected nerves, reducing inflammation, and giving you longer-lasting pain relief. If your pain persists despite conservative treatment, your provider talks with you about surgery. The type of procedure you need depends on the underlying problem. You may need spinal decompression, removal of bone spurs, or a discectomy. During a decompression procedure, your provider may remove part of the bone to enlarge the spinal canal. After removing some of the bone or a disc, your provider then does a spinal fusion to stabilize and strengthen your spine. If you need relief from ongoing back or neck pain, book an appointment online or call Center for the Functional Restoration of the Spine today.

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