Understanding Spinal Stenosis

In this episode, Dr. Joe Sheppard explains spinal stenosis, a common condition that occurs when the spaces within the spine narrow and place pressure on the spinal cord or nerves. He discusses how spinal stenosis most commonly affects the neck (cervical spine) and lower back (lumbar spine) and is often associated with age-related changes such as disc degeneration, arthritis, bone spurs, thickened ligaments, and previous injuries.

Dr. Joe reviews the most common symptoms, including back or neck pain, numbness, tingling, weakness, difficulty walking, balance problems, and the classic relief many patients experience when sitting down or leaning forward.

The episode also covers how spinal stenosis is diagnosed through physical examinations and imaging studies such as X-rays and MRIs. Dr. Joe explains that while chiropractic care cannot reverse spinal narrowing, it may help improve spinal mobility, posture, movement patterns, and overall function. He also discusses lifestyle modifications, exercise recommendations, and the importance of staying active.

Finally, he highlights warning signs that require immediate medical attention, including severe weakness, loss of bowel or bladder control, and worsening neurological symptoms.

Key Takeaway: While spinal stenosis is a common age-related condition, many people can successfully manage their symptoms and maintain an active lifestyle through proper care, exercise, and conservative treatment options.

Transcript

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In the time it takes you to get home, work, or play, Dr. Joe's podcast will inform and educate you on chiropractic, nutrition, and fitness, keeping you and your family up to date on current products, health tips, and optimized living with chiropractic care. And here's your host, Dr. Joe Shepherd.

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Hello. My name is Dr. Joe Shepherd of Shepard Chiropractic. Today on Dr. Joe's Power On Podcast, episode number 49, we're talking about a condition that sounds a little intimidating when people first hear it, but it is actually very common, especially as we get older. That condition is called spinal stenosis. Now, I'll tell you right away, most patients I meet who have been diagnosed with spinal stenosis usually say the same thing. I was told I have it, but I don't really know what it means. So today we're going to break it down in a simple, practical way, what it is, why it happens, what symptoms to look for, and how conservative care, like chiropractic, fits into the picture. So kick off your shoes, take a deep breath, maybe roll those shoulders back, and let's get aligned together. So what is spinal stenosis? Well, spinal stenosis is simply a narrowing of the spaces within your spine. Inside your spine, you have a canal that houses and protects the spinal cord and nerve roots. Think of it like a highway system for your nervous system. Your brain is sending signals down this roadway to control everything in your body. When that space becomes narrower, it's like a traffic jam on the highway. The nerves don't necessarily stop working, but they can become irritated, compressed, and less efficient. And that's when symptoms begin to show up. Spinal stenosis most commonly affects two areas, the cervical spine, which is in your neck, and the lumbar spine, which is your lower back. You know, it can occur in your mid back or thoracic spine, but that's much less common. So when someone says I have spinal stenosis, what they're really saying is there is less space than normal around my spinal cord and nerves. So why does spinal stenosis happen? Well, one of the most important things to understand is that spinal stenosis is usually not caused by a single event. Instead, it tends to gradually develop over time. Let's walk down through the most common contributors. Degenerative disc changes. As we age, our discs naturally begin to lose their water content and their height. You can think of disks like a shock absorber between the bones of your spine. When they're healthy and full of fluid, they help maintain spacing and movement. But as they degenerate, they flatten slightly, and that reduces the available space for your nerves. Okay, arthritis and bone spurs. Well, osteoarthritis in the spine can lead to the formation of bone spurs or calcium deposits. These are very tiny bony overgrowths that develop as the body responds to joint wear and tear. The problem is those spurs don't always stay neatly in one place. Sometimes they grow into areas where nerves travel, contributing to the narrowing in your spinal canal. Okay, thickened ligaments. Well, your spine is supported by ligaments that help stabilize movement. And over time, especially with chronic stress or degeneration, those ligaments can thicken. When they thicken, they take up more space inside the spinal canal, again contributing to that narrowing effect. Bulging or herniated discs, a disc that bulges or herniates can push into the space where the nerves are located. And depending on the severity and location, this can contribute significantly to stenosis-like symptoms. Okay, previous injuries, you know, trauma such as falls, car accidents, or repetitive stress injuries can change spinal alignment and mechanics. And over time, these changes can accelerate degeneration and narrowing. So congenital factors is another one. Some people are just simply born with a smaller spinal canal. They may go through most of their life without symptoms, but as age-related changes accumulate, symptoms can appear earlier or more noticeably. So common symptoms, so let's talk about what spinal stenosis actually feels like. And symptoms depend on where the narrowing is occurring. So let's talk about the lower back spinal stenosis first. This is the most common presentation. Typical symptoms include low back pain, pain radiating into the buttocks or down the legs, numbness or tingling in the legs, leg weakness, difficulty standing for long periods, symptoms that worsen with walking, relief when sitting or bending forward. One of the classic descriptions patients give us is I can walk, but after a short distance I have to stop and sit down. Or even more specifically, I lean over a shopping cart when I'm at the grocery store because it actually makes it feel better. That leaning forward opens up the space in the spinal canal slightly, which can can reduce the nerve pressure or nerve irritation. Okay, cervical or neck spinal stenosis. When stenosis occurs in the neck, symptoms can include neck pain or stiffness, shoulder or arm pain, numbness or tingling in the arms or hands, weakness in grip strength, balance issues, coordination problems. In many more advanced cases, when the spinal cord itself is inspected, patients may notice changes in walking stability and fine motor skills. That's something that's always deserved very careful evaluation and attention. So how was spinal stenosis diagnosed? Well, diagnosis usually starts with a detailed exam that's looking at range of motion, reflexes, muscle strength, sensation testing, posture and movement patterns, and from there imaging may be recommended. Most commonly, x-rays are taken to see the bony structure and alignment, MRI scans to evaluate soft tissue disc and nerve spaces, and CT scans in some cases for detailed bone visualization. These tools help confirm whether narrowing is present and how significant that it is. Can chiropractic help with spinal stenosis? Well, this is one of the most important questions people ask me. And the honest answer is chiropractic care does not reverse significant spinal narrowing or cure spinal stenosis at all. But what it does mean, in fact, that many patients with spinal stenosis can benefit from conservative care focused on improving how the spine functions. At Shepherd Chiropractic, our focus is often on helping patients improve spinal mobility. When the joints in the spine become stiff and restricted, it can increase the stress on the surrounding structures. Very specific and gentle chiropractic adjustments may help restore motion where appropriate, which can improve overall movement efficiency. You can reduce mechanical stress. Well, even if the structural narrowing remains, how the spine moves and loads really matters, and better movement patterns can sometimes reduce irritation on the nerves and surrounding tissue. Improving posture and alignment, well, posture plays a major role in spinal loading. Forward head posture, slouching, or even poor sitting mechanics can increase stress on already sensitive areas. Small corrections over time can make a very meaningful difference. Support daily movement, that's a big key. One of the biggest challenges with spinal stenosis is that people often become less active because the movement can feel very uncomfortable. But reduced movement can actually make stiffness worse over time. A big goal is helping patients stay active safely is the key. Lifestyle and exercise guidelines, well, depending on the individual, you know, recommendations include gentle stretching, core stretching, walking patterns, stationary bike, ergonomic adjustments at work, sleeping position strategies. Many patients with spinal stenosis actually can tolerate flexion-based activities better, like leaning slightly forward, such as cycling. So what tends to help people feel better? Well, while everyone is different, there are some general patterns that we see. Many individuals feel better with the forward flexion position. Short bouts of movement through the day, low impact aerobic activity. Swimming is excellent also in avoiding prolonged standing still in one position. For example, walking may be helpful, but standing in one position may be very aggravating. That's why pacing and movement patterns are often key. One is mild, moderate, and severe. And what I've seen over time is that conservative chiropractic care gets the best results for mild to moderate stenosis. Usually with severe stenosis, there usually has to have a neurosurgical consultation to be evaluated at that time. And that's usually when I refer out when there's this severe stenosis. So, you know, when should you seek urgent care? Well, there are certain symptoms that you should always be taking seriously. And if someone experiences sudden or severe weakness, significant balance changes, loss of bladder and bowel control, or rapidly worsening numbness, and severe neurological changes. And those situations require immediate medical evaluation. Those are signs that nerve involvement may be more serious. So here's my final thoughts. Well, spinal stenosis is a condition involving narrowing in the spinal canal that can lead to nerve irritation and symptoms like pain, numbness, tingling, or weakness. While it's often associated with aging, it doesn't mean someone who is automatically limited or unable to stay active either. Many people can manage it well with the right combination of movement, lifestyle changes, and conservative chiropractic care. The key idea is this. Even if we can't change every structure detail of the spine, we can offer improve how the spine functions, how the nerve flow is continued, and how a person feels day to day. At Shepherd Chiropractic, our goal is to help patients move better, function better, and stay as active as possible in their daily lives. And if you've been diagnosed with spinal stenosis or you're experiencing some symptoms similar to what we said, it may be worth getting evaluated to see what options may make sense for you. So thanks for listening to Dr. Joe's podcast. I have found if you found this helpful, feel free to share it with someone who might be dealing with back or neck issues. And as always, if you're in the Cincinnati area, you can reach out to Shepherd Chiropractic to schedule an appointment. We are located in Cincinnati, Ohio. And as always, before you go, if this episode helped you in any way, would you do me a very small favor? Follow the podcast so you never miss an episode. And think of just one person, maybe a friend, family member, or coworker, who would benefit from what you heard today, and send it to them. Personal recommendations are how this podcast will grow. And I truly appreciate your support. Until next time, keep your power on and have a great week, and thanks for listening.

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Thanks for joining us on this episode of Dr. Joe's Podcast. Discover more insights on chiropractic, nutrition, and fitness on next week's episode and at Shepherdchiroptic.com.