Is Spinal Stenosis Causing Your Chronic Back Pain?  

About 80% of adults in the US have had at least one episode of back pain, according to the National Institutes of Health, and you’ve had far more than that. In fact, it’s hard to remember a time when your back didn’t ache. 

At Palm Beach Pain Institute in Delray Beach, Florida, board-certified pain management physician Marcie Merson, MD, and our team are dedicated to providing relief for your back pain. Though back pain can be caused by many different conditions, one of the most common reasons for pain in your lower back — especially as you age — is spinal stenosis.

What happens as your spine ages

Back pain usually originates in the lower part of your spine, known as the lumbar spine, which is made up of five large vertebrae stacked one on top of the other. Each vertebra is made up of a large bony disc and two facet joints. The facet joints connect the vertebrae to one another, allowing you to move your spine.

The vertebrae also protect your spinal cord, which runs through a canal in the center of the stacked vertebrae. Over time, the canal can narrow because of arthritis or other conditions, so the spinal cord doesn’t have as much space as it did when you were younger.

The narrowed spinal canal, known as spinal stenosis, puts pressure on your spinal cord and also on the spinal nerve roots. Spinal stenosis causes symptoms such as:

• Pain in your lumbar spine  
• Sciatica (shooting pains down buttocks and leg)
• Numbness in buttocks or leg
• Foot “slapping” ground while walking
• Pain relief when leaning forward or sitting
• Balance problems
• Incontinence
• Paralysis

Not everyone who has spinal stenosis experiences symptoms. However, about 95% of people aged 50 or more have degenerative changes in the spine. Although most cases of spinal stenosis occur after age 60, some may have congenital spinal stenosis that causes symptoms between the ages of 30 and 50. 

What causes spinal stenosis

Spinal stenosis is usually caused by arthritis. As you age, the rubbery, shock-absorbing discs that separate your vertebrae begin to lose water content and shrink. As the discs narrow and degenerate, the facet joints in your vertebrae start to bear the weight of your entire body, which puts pressure on the bones and may make them grind against one another.

When your bones grind against one another, it degrades the cartilage that protects your facet joints. Your body then produces more bone to make up for the lost cartilage, resulting in bony protrusions called bone spurs. Bone spurs narrow your spinal column.

Other causes of spinal stenosis include:

• Bone overgrowth from Paget’s disease or other conditions
• Thickened ligaments
• Spinal injuries
• Herniated or slipped discs
• Tumors

Diagnosing spinal stenosis

When you come to Palm Beach Pain Institute with back pain, be sure to let Dr. Merson know about any other symptoms you have. To determine if you have spinal stenosis, she conducts a series of tests, including:

• Physical examination and palpation of the spine
• X-rays to check for bone spurs and degenerated discs
• X-rays while leaning forward and backward to check for spinal hypermobility or instability
• Magnetic resonance images to check the integrity of discs, nerves, muscles, and spinal cord

She may order other studies to determine if your nerves are being impinged by the narrowed spinal canal and to check for other conditions that could be causing your pain.

Treating spinal stenosis

If Dr. Merson diagnoses spinal stenosis, she designs a treatment plan based on the condition of your vertebrae, discs, and nerves. She may combine a number of treatment options, including:

• Lifestyle changes, such as more activity to support spinal health
• Physical therapy to strengthen the muscles that support your spine
• Anti-inflammatory medications
• Epidural injections
• Spinal cord stimulator trials and implants

To find out why you have chronic back pain and get relief, request an appointment with Dr. Merson today by calling our office at 561-499-7020 or using the online booking tool.