Lumbar and Cervical Spinal StenosisDr. Howard Liss treats disorders that cause pain and disability by providing consultative services and soft tissue and joint injections when needed. When medically appropriate, he makes specific referrals for diagnostic testing (lab work, imaging, electrodiagnosis), physical and occupational therapy, interventional procedures (epidurals and facet joint injections), and surgery.
Medically speaking, stenosis describes a narrowing of a specific channel. Thus, in the case of spinal stenosis, it is a narrowing of the bone channel, which is home to the spinal nerves and spinal cord. While spinal stenosis is a congenital issue for some individuals, it is part of a degenerative process for others that occurs over time and leads to nerve compression. Pain, weakness and changes in sensation are often experienced. Specifically, lumbar spinal stenosis resembles symptoms of sciatica. It may cause pain, tingling and weakness that radiates or pulses from the low back to the buttocks and down the leg. Yet, symptoms are also similar to claudication, which is a vascular condition characterized by leg pain with walking. Even so, there are subtle differences. For instance, individuals with lumbar spinal stenosis note that they experience the onset of pain when walking but feel relief when sitting down. They may also report that they feel some sense of relief when walking in a flexed forward position, such as leaning forward on a stroller or shopping cart.
Though less common, cervical spinal stenosis is more serious. When patients experience neck pain as a result of spinal stenosis, there is a chance that the spinal cord is compressed (myelopathy). While this can cause pain and weakness, it can also cause paralysis. The following symptoms are indicative of cervical spinal stenosis with myelopathy:
- Feeling of heaviness in the legs
- Inability to walk at a fast pace
- Change in fine motor skills (handwriting or buttoning a shirt)
- Occasional shooting pain in arms and legs
- Arm pain
While other sources of back and neck pain can result from injury or trauma, spinal stenosis is a progressive and degenerative issue that becomes more significant with age. As changes occur such as narrowing of the channel in the spine, individuals naturally become less active and gradually assume a “hunched over” position.
Non-Surgical Treatment for Spinal Stenosis
Because decreased levels of physical activity can contribute to the severity of spinal stenosis and possibly disability, exercise and physical therapy have become a tried and true non-surgical treatment and pain management solution. Yet, if patients are already experiencing pain, epidural injections prove to relieve symptoms of spinal stenosis so that they can engage in rehabilitation.
With a multidisciplinary approach, physiatrists are in the best position to develop a treatment protocol, as well as a timeline for patients with spinal stenosis. Physiatrists understand that while activity is an important part of treatment for spinal stenosis, it must be supervised and some exercises will require modification. For example, stationary biking may be more suitable for patients with lumbar stenosis, as they typically experience more pain when in the upright position. As patients are counseled in body mechanics, they will learn to make choices that do not worsen their symptoms. Anti-inflammatory medication and muscle relaxers are often part of treatment as well.
Physiatrists work to develop treatment that maximizes a patient’s level of functioning—both physically and mentally. Thus, while there is a preliminary focus on reducing pain and establishing a treatment routine, there are options for counseling, as this is a vital component of overall wellness.
At the Howard Liss, M.D. Rehabilitation Institute, patients can rely on Dr. Liss to put together the right treatment, therapy and rehabilitation plan to ensure the most optimal outcome. Dr. Liss works closely with other specialists required to rehabilitate patients suffering from chronic pain or serious injuries, and Dr. Liss will refer patients as needed to ensure appropriate treatment. With extensive education and exposure to a variety of conditions that affect the cervical and lumbar spine, bones, nerves, joints, ligaments, tendons, muscles, brain, and spinal cord, Dr. Liss is uniquely positioned to help patients manage their pain and maximize their functioning.
Contact the Howard Liss, M.D. Rehabilitation Institute today to schedule an appointment with Dr. Liss.