Back Clinic Chiropractic Spine Care Team. The spine is designed with three natural curves; the neck curvature or cervical spine, the upper back curvature or thoracic spine, and the lower back curvature or lumbar spine, all of which come together to form a slight shape when viewed from the side. The spine is an essential structure as it helps support the upright posture of humans, it provides the body with the flexibility to move and it plays the crucial role of protecting the spinal cord. Spinal health is important in order to ensure the body is functioning to its fullest capacity. Dr. Alex Jimenez strongly indicates across his collection of articles on spine care, how to properly support a healthy spine. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
The spine is the body’s central highway, with the spinal canal as the main lane that handles all the traffic. There are entrances and exits, or spinal cavities, that allow the nerves to branch off the spinal cord and run throughout the body. A traffic jam develops during lane closures, accidents, or construction at an entrance or exit. Lateral recess stenosis causes the narrowing of the spine’s lateral recess/Lee’s entrance, which can compress nerves, impede nerve circulation, and cause painful symptoms.
Lateral Recess Stenosis
The spinal column provides a strong and flexible structure for the spinal cord. The nerves travel from the spinal cord through various openings and passageways to the rest of the body. One of the openings is known as the lateral recess. Stenosis means narrowing. When a lateral recess in a vertebra develops stenosis, the nerve in that area can get jammed/pinched with no room to move, causing varying symptoms and sensations.
Symptoms
Depending on where the stenosis is taking place (neck, middle or low back), common symptoms of lateral recess stenosis can include:
Back pain that can spread out to other areas.
Cramping that can spread out to other sites.
Radiating pain that worsens with movement and eases with rest.
Numbness or weakness of the legs or arms.
Electrical tingling sensations down the leg or arm.
Muscle groups around the stenosis area are built up to take the pressure off of the area, alleviating symptoms.
Medications
A doctor or spine specialist may recommend or prescribe medication to ease symptoms. These include:
Tylenol – acetaminophen.
NSAIDS – Advil/ibuprofen or Aleve/naproxen.
Muscle relaxers
Steroid Injections
According to a study, neurogenic claudication is the main reason for disability and loss of independence in the elderly.
Neurogenic claudication describes pain and weakness in the buttocks and legs during physical activity that originates from the nerves, not the vessels.
This can happen from inflammation and swelling around a compressed nerve.
A steroid injection can decrease inflammation for several months.
Surgery
If activity modification, NSAIDs, bracing, and physical therapy don’t work or provide adequate relief, a doctor or specialist could recommend surgery.
Drug Design, Development and Therapy (2014) “Steroid for epidural injection in spinal stenosis: a systematic review and meta-analysis” doi.org/10.2147/DDDT.S78070
Lee, Seung Yeop, et al. “Lumbar Stenosis: A Recent Update by Review of Literature.” Asian spine journal vol. 9,5 (2015): 818-28. doi:10.4184/asj.2015.9.5.818
Liu, Kuan, et al. “Steroid for epidural injection in spinal stenosis: a systematic review and meta-analysis.” Drug design, development, and therapy vol. 9 707-16. Jan 30, 2015, doi:10.2147/DDDT.S78070
Subluxation is when a joint shifts out of alignment, which can happen to any joint in the body. Spinal subluxation indicates a misalignment of one or more portions of the spinal vertebrae. It is common in the spine from all the reaching, bending, twisting, and flexing the body goes through. Spinal subluxations, if left untreated, can cause disc degeneration, permanent nerve damage, neurological conditions, and chronic pain symptoms. A subluxation chiropractor will realign and decompress the spine combined with massage therapy to relax the muscles and restore mobility and function.
Subluxation Chiropractor
Some subluxations don’t cause any problems or pain, but that doesn’t mean they aren’t affecting the back and body. A spinal subluxation can cause long-term problems by:
Research shows that spinal subluxations can affect many facets of the body. Long-term effects may include:
Sleep problems
Low energy
Brain fog
Mood swings
Anxiety and depression
Digestive issues
Respiratory problems
Bone spurs
Spinal arthritis
Chiropractic Care
When the spine is out of alignment, it can cause issues throughout the body. Changes in one area affect the rest of the body. A subluxation chiropractor looks at the spine’s neurological and mechanical components and aims to reset everything back into its proper position. Similar to the way a massage helps the mind and body relax and de-stress, a spinal adjustment helps by:
Increasing circulation
Relieving discomfort and pain
Releasing tension
Improving mood
Reducing stress levels
Improving sleep function
Increasing energy levels
When the spine is properly aligned, the body can operate at its full potential.
Green, J D et al. “Anterior subluxation of the cervical spine: hyperflexion sprain.” AJNR. American journal of neuroradiology vol. 2,3 (1981): 243-50.
Meyer, S. “Thoracic spine trauma.” Seminars in roentgenology vol. 27,4 (1992): 254-61. doi:10.1016/0037-198x(92)90004-l
Neva MH, Häkkinen A, Mäkinen H, et al. High prevalence of asymptomatic cervical spine subluxation in patients with rheumatoid arthritis waiting for orthopedic surgeryAnnals of the Rheumatic Diseases 2006;65:884-888.
Nourollahi, Maryam, et al. “Awkward trunk postures and their relationship with low back pain in hospital nurses.” Work (Reading, Mass.) vol. 59,3 (2018): 317-323. doi:10.3233/WOR-182683
Vernon, Howard. “Historical overview and update on subluxation theories().” Journal of chiropractic humanities vol. 17,1 (2010): 22-32. doi:10.1016/j.echu.2010.07.001
Herniated disc injuries and the time it takes to heal depend on the injury’s cause, the severity, and where it occurred along the spine. Symptoms can last a few days to months. Chiropractic treatment, massage therapy, and decompression realign the spine and return the disc to its correct position. Still, the herniated disc signs it is returning to normal can take time as the rest of the spine and body adjust to the realignment.
Herniated Disc Signs It Is Returning To Normal
Most cases take a few weeks with healing time depending on health conditions, physical activity level, and age. However, in severe cases, a herniated disc can take up to several months to fully heal, but discomfort symptoms usually resolve sooner.
Expectations From a Healing Disc
Resting the spine and taking it easy after the injury is recommended.
Too much rest is not recommended as it can cause muscle stiffness.
While the herniated disc is healing, a primary doctor may prescribe anti-inflammatories or muscle relaxants to help ease discomfort.
A chiropractor and/or physical therapist can teach exercises and stretches to relieve pressure on nerves, loosen tight muscles, and improve circulation.
Signs The Herniated Disc Is Healing
Most herniated discs cause significant pain in the back and neck from the nervous system, causing some of the muscles of the low back or neck to spasm to protect the area from further damage.
Usually, the muscle spasms relax within the first days of the injury.
After spinal decompression, neurological symptoms like the sharp, shooting pain down a nerve in the arm or leg are the first symptoms to go away.
Then muscle weakness along the path of the nerve goes away.
Numbness in the extremities can linger around longer.
Length of Time
The wear and tear of adult spinal discs, combined with unhealthy posture habits, job occupation, previous injuries, etc., decrease blood circulation.
This is why it can take some time to heal completely, as the entire blood supply needs to reset to optimal circulation.
Nerve compression causing aches and pain sensations down the nerves can also take time.
Regular Activity
Returning to regular activities depends on the individual’s case and condition. It is essential not to overdo things that can cause excessive loading of the spine before the disc has fully healed, which increases the risk of re-herniation and other injuries.
Inactivity can slow the healing process and cause inflammation.
Patients are encouraged to return to activities that generate gentle motion to stimulate the stabilizing muscles to function properly and increase blood circulation to the injured area.
Individuals are recommended to:
Learn posture improvement when walking, sitting, standing, and sleeping.
Adjust sleep patterns.
Incorporate anti-inflammatory nutrition during the healing process.
This provides a mechanical and biological environment that eventually becomes a personalized exercise physical therapy program.
DOC Spinal Decompression
References
Díez Ulloa, Máximo Alberto. “Role of Microangiogenensis in Disc Herniation Healing.” Journal of investigative surgery: the official journal of the Academy of Surgical Research vol. 34,6 (2021): 685. doi:10.1080/08941939.2019.1682725
Keramat, Keramat Ullah, and Aisling Gaughran. “Safe physiotherapy interventions in large cervical disc herniations.” BMJ case reports vol. 2012 bcr2012006864. 18 Aug. 2012, doi:10.1136/bcr-2012-006864
Stoll, T et al. “Physiotherapie bei lumbaler Diskushernie” [Physiotherapy in lumbar disc herniation ]. Therapeutische Umschau. Revue therapeutique vol. 58,8 (2001): 487-92. doi:10.1024/0040-5930.58.8.487
Swartz, Karin R, and Gregory R Trost. “Recurrent lumbar disc herniation.” Neurosurgical focus vol. 15,3 E10. 15 Sep. 2003, doi:10.3171/foc.2003.15.3.10
Diagnosing ankylosing spondylitis usually involves multiple tests. When doctors order blood tests to diagnose ankylosing spondylitis, an individual is experiencing worsening symptoms in their back and joints. Often, a blood test diagnosis means the doctor is looking for evidence of anything else that could be causing the symptoms. However, blood tests by themselves cannot definitively diagnose ankylosing spondylitis, but when combined with imaging and assessment, they can provide important clues that point to the answers.
Ankylosing Spondylitis Blood Test Diagnosis
Ankylosing spondylitis is arthritis that primarily affects the spine and hips. It can be difficult to diagnose as no single test can provide thorough information for a definitive diagnosis. A combination of diagnostic tests are utilized, including a physical exam, imaging, and blood tests. Doctors are not only looking for results that will point to ankylosing spondylitis, but they are looking for any results that might point away from the spondylitis results that might provide a different explanation for symptoms.
Physical Exam
The diagnostic process will begin with the individual’s medical history, family history, and physical exam. During the exam, the doctor will ask questions to help rule out other conditions:
How long have symptoms been presenting?
Do symptoms get better with rest or exercise?
Are the symptoms getting worse or staying the same?
Are the symptoms worse at a particular time of day?
The doctor will check for limitations in mobility and palpate tender areas. Many conditions can cause similar symptoms, so the doctor will check to see if the pain or lack of mobility is consistent with ankylosing spondylitis. The feature sign of ankylosing spondylitis is pain and stiffness in the sacroiliac joints. The sacroiliac joints are located in the lower back, where the base of the spine and pelvis meet. The doctor will look at other spinal conditions and symptoms:
Back pain symptoms caused by – injuries, posture patterns, and/or sleeping positions.
The HLA-B27 gene corresponds with ankylosing spondylitis; if an individual has it, one of their parents has it.
Imaging
X-rays often serve as the first step to a diagnosis.
As the disease progresses, new small bones form between the vertebrae, eventually fusing them.
X-rays work best at mapping the disease progression than the initial diagnosis.
An MRI provides clearer images in the early stages as smaller details are visible.
Blood Tests
Blood tests can help rule out other conditions and check for signs of inflammation, providing supportive evidence along with the results of imaging tests. It typically only takes about a day or two to get the results. The doctor may order one of the following blood tests:
Antinuclear antibodies, or ANA, go after the proteins in the cell’s nucleus, telling the body its cells are the enemy.
This activates an immune response that the body fights to eliminate.
A study determined that ANA is found in 19% of individuals suffering from ankylosing spondylitis and is higher in women than men.
Combined with other tests, the presence of ANA provides another clue to a diagnosis.
Gut Health
The gut microbiome plays an important role in triggering the development of ankylosing spondylitis and its treatment.
Tests to determine the gut’s health can give a doctor a complete picture of what is happening inside the body.
Blood test diagnoses for ankylosing spondylitis and other inflammatory conditions rely heavily on piecing together different tests alongside clinical exams and imaging.
Causes, Symptoms, Diagnosis, and Treatment
References
Cardoneanu, Anca, et al. “Characteristics of the intestinal microbiome in ankylosing spondylitis.” Experimental and therapeutic medicine vol. 22,1 (2021): 676. doi:10.3892/etm.2021.10108
Prohaska, E et al. “Antinukleäre Antikörper bei Spondylitis ankylosans (Morbus Bechterew)” [Antinuclear antibodies in ankylosing spondylitis (author’s transl)]. Wiener klinische Wochenschrift vol. 92,24 (1980): 876-9.
Sheehan, Nicholas J. “The ramifications of HLA-B27.” Journal of the Royal Society of Medicine vol. 97,1 (2004): 10-4. doi:10.1177/014107680409700102
Wenker KJ, Quint JM. Ankylosing Spondylitis. [Updated 2022 Apr 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK470173/
Xu, Yong-Yue, et al. “Role of the gut microbiome in ankylosing spondylitis: an analysis of studies in the literature.” Discovery medicine vol. 22,123 (2016): 361-370.
Middle back pain is usually caused by unhealthy posture, improper lifting or twisting, and minor injuries like muscle strains, sprains, and herniated discs. Thoracic herniated discs are less common than neck or low back herniations because of the thoracic vertebrae’s size and rigidity, but they do happen. Chiropractic care can treat thoracic herniated discs and prevent future episodes.
Thoracic Herniated Disc
The 12 thoracic vertebrae between the neck and the lumbar spine make up the largest and least flexible area. The rib cage adds:
Protection
Support
Stabilization of the spine
Symptoms
Herniated discs happen when the soft, gel-like layer of the shock-absorbing intervertebral disc bulges into or leaks through the disc’s tough outer layer. Due to the location, a herniated disc can cause various issues to the middle back, chest wall, and/or abdominal areas around the injured vertebrae. This displacement can cause:
Inflammation
Compression to the spinal nerves or spinal cord
Tingling
Numbness
Pain
Weakness
If the lower thoracic region is herniated, symptoms can radiate to one or both lower extremities.
Radiculopathy
If the herniation compresses a thoracic spinal nerve, it can cause radiculopathy or pain that radiates down the nerve and out from the spine into the surrounding muscles. The symptoms can present around the rib cage or upper abdominal area. A large disc herniation can compress the spinal cord inside the spinal canal. This is a condition called myelopathywhich can cause:
Numbness
Tingling
Weakness in one or both lower extremities
Sometimes bowel and bladder dysfunction
In severe cases, paralysis
Causes
Degenerative disc disease and trauma like vehicle collisions or falls are the most common causes of thoracic herniation.
Individuals between 30 and 50 are more likely to be affected.
As the body ages, the disc’s soft inner layer loses hydration, making it less effective as a shock absorber.
The tough outer layer loses elasticity, increasing the risk of disc tears.
Chiropractic Care
A chiropractor or neurologic physical therapist can personalize a herniated disc exercise treatment plan to reduce pain, improve strength and posture, and increase mobility.
Therapeutic massage can be useful in managing pain and decreasing inflammation.
Spinal epidural injections can be used with physical therapy to help manage pain and allow the body to heal independently.
Recommendations
Avoid bending, lifting, reaching, and twisting.
Apply an ice pack or cold compress for 15- to 20-minute intervals every two hours.
Sit in chairs with a firm back to support the spine.
When sleeping, place a small pillow under the head and knees to keep the spine in a neutral position to prevent pressure on the herniated region.
Avoid too much rest, which can worsen the injury.
Gentle physical activity will maintain circulation and keep the muscles strong.
Surgery
Most cases of thoracic herniation do not require surgery. Surgery could be recommended if there is intolerable pain, neurological issues, and conservative treatments are not working. A spine specialist can determine if surgery is necessary based on the injury’s size, type, and location. Spinal surgery will remove all or part of the herniated disc compressing a nerve root. Common surgical procedures include:
Court, C., E. Mansour, and C. Bouthors. “Thoracic Disc Herniation: Surgical Treatment.” Orthopaedics & Traumatology: Surgery & Research 104, no. 1 (2018). doi.org/10.1016/j.otsr.2017.04.022.
Dydyk, Alexander M, Ruben Ngnitewe Massa, and Fassil B Mesfin. “Disc Herniation – Statpearls – NCBI Bookshelf.” National Library of Medicine, January 18, 2022. www.ncbi.nlm.nih.gov/books/NBK441822/.
Yoon, Wai Weng, and Jonathan Koch. “Herniated Discs: When Is Surgery Necessary?” EFORT Open Reviews 6, no. 6 (2021): 526–30. doi.org/10.1302/2058-5241.6.210020.
Spondyloarthritis is a group of inflammatory, immune-mediated diseases that cause chronic low back pain, inflammation, irritating aches, and pains. The conditions mostly affect the spine but can affect joints in the arms, legs, hips, skin, eyes, and intestines. Spondylitis types can significantly affect daily function, physical activity and compromise bone health.
Spondylitis Types
The main types include:
Ankylosing spondylitis
Psoriatic arthritis
Enteropathic arthritis
Reactive arthritis
Juvenile spondylitis
Undifferentiated spondylitis
Axial Spondylitis vs. Peripheral Spondylitis Types
Axial means relating to the body’s central region, as in the trunk and head.
Axial spondyloarthritis is arthritis and inflammation in the hips and spine.
The condition starts before age 45.
The pain typically starts in the low back but can begin in the neck or other regions.
Characterized by back pain, usually in the lower back and/or buttocks.
Morning back stiffness lasting 30 minutes or longer.
Sacroiliac joint inflammation can also present.
The back pain gradually progresses.
Lasts longer than three months.
Improves with physical movement, not with rest.
Peripheral spondyloarthritis is arthritis and inflammatory pain in the peripheral joints and tendons and does not include the spine.
Individuals can have peripheral and axial spondylitis symptoms simultaneously.
Diagnosis depends on whether symptoms are primarily peripheral or axial.
Spondylitis and Spondylosis
Spondylosis and spondylitis are similar in they cause pain and inflammation in the back and hips. The difference is in each condition’s triggers.
Spondylitis is a disease in which the body’s immune system degrades joints, causes inflammation, overproduces bone formation, and causes bone fusion.
Spondylosis is a category of arthritis that presents as the spine ages from normal wear and tear.
It happens during the degeneration of the spine’s discs and joints.
It also presents when bone spurs develop on the spine’s vertebrae.
Ankylosing Spondylitis
Ankylosing spondylitis is the most common form of arthritis affecting the spine, other joints, and body regions. The condition causes spinal joint inflammation causing extreme discomfort and chronic pain. In some cases, the inflammation progresses to ankylosis, where spine sections fuse and become immobile. Other body areas that can trigger inflammation include:
The ribs
Heels
Shoulders
Hips
Small joints of the feet and hands.
Ankylosing spondylitis symptoms vary from person to person. Common early symptoms include:
There is general discomfort, appetite loss, and mild fever early in the condition.
Persistent stiffness and pain in the buttocks and low back, gradually progressing over a couple of weeks or months.
The pain and stiffness can travel into the neck and spine within months or years.
The pain is usually spread out and dull.
The stiffness and pain are worse in the morning and night and improve with light exercise or a warm shower.
The pain typically becomes chronic, lasts for a minimum of 3 months, and can be felt on both sides.
Tenderness and pain in the hips, thighs, shoulder blades, heels, and ribs may also occur.
Treatment approaches include applications of ice and heat to reduce swelling, increase circulation, and decrease joint pain, posture exercises, stretches, physical therapy, and medication.
Psoriatic Arthritis
Psoriatic arthritis causes swelling, pain, and inflammation in the small joints of the hands and feet; however, the joints of the knees, ankles, and wrists can also be affected. Psoriasis is a rash that causes scaly skin patches.
Individuals can develop dactylitis when a finger or toe swells between the surrounding joints.
Spinal stiffness and pain can present.
Typically the ends of the finger joints are most affected and experience pain and inflammation.
Medications frequently utilized to treat ankylosing spondylitis can be used.
Exercise helps preserve the range of motion and maintain strength.
Isometric exercises work muscles without joint motion reducing the risk of further injury to inflamed joints.
Occupational and physical therapy can significantly assist in optimizing arthritic joint function.
Enteropathic Spondylitis
Enteropathic Arthritis is chronic inflammatory arthritis linked to inflammatory bowel disease. The most recognized are Crohn’s and ulcerative colitis.
The peripheral limb joints and sometimes the whole spine are the most prevalent body areas afflicted with enteropathic spondylitis.
The main symptom is intestine inflammation, including bowel and joint pain and/or inflammatory back pain.
Other symptoms can include weight loss, blood in the stool, abdominal pain, and/or chronic diarrhea.
Managing enteropathic arthritis typically means managing the underlying bowel disease.
Juvenile Spondyloarthritis
Juvenile spondyloarthritis is a group of childhood rheumatic diseases that cause arthritis before age 16 and can continue through adulthood. Juvenile spondyloarthritis encompasses:
Enteropathic arthritis
Enthesitis-related arthritis
Undifferentiated spondyloarthritis
Psoriatic arthritis
Reactive arthritis
Juvenile ankylosing spondylitis
Juvenile spondyloarthritis causes inflammation and pain in joints in the lower body, like the ankles, hips, knees, and pelvis. Other body areas that could be affected include:
The bowels
Eyes
Skin
Spine
Lethargy and fatigue can also present. The symptoms can be unpredictable and episodic, appearing and disappearing without a specific cause. The condition cycles between flare-ups and remission. Common treatment approaches include:
Medication
Exercise
Posture training
Physical therapy, medication
Ice and heat to decrease joint pain and relax muscles.
In severe cases, surgery could be recommended.
Reactive Arthritis or Reiter’s Syndrome
Reactive arthritis is arthritis that causes pain and inflammation in the mucous membranes, bladder, skin, joints, eyes, and genitals.
Reactive arthritis is believed to be a reaction to an infection, usually in the gastrointestinal or urinary tract.
Reactive arthritis does not affect the sacroiliac joints and spine in most cases.
Reactive arthritis is typically treated with nonsteroidal anti-inflammatory medications, steroids, and rheumatoid arthritis medications.
A physician could prescribe antibiotics if a bacterial infection brought on reactive arthritis.
Undifferentiated Spondyloarthritis
Undifferentiated spondyloarthritis is where the signs and symptoms of spondylitis don’t meet the criteria for a specific rheumatoid disorder. Individuals diagnosed with undifferentiated spondyloarthritis will have one or more of the symptoms that include:
Fatigue
Back inflammation
Back pain
Buttock pain that alternates or presents on both sides.
Swollen toes or fingers
Heel pain
Arthritis in the small joints.
Arthritis in the large limb joints.
Enthesitis or inflammation where the ligament or tendon connects to the bone.
Eye inflammation
Individuals can also present symptoms of other spondylitis types, like psoriatic or ankylosing.
Treatment approaches include:
Exercise
Physical therapy
Posture training
Ice and heat to decrease joint pain and loosen up muscles.
Spondylitis Types Diagnosis of Spondyloarthritis
References
Carron, Philippe, et al. “Peripheral spondyloarthritis: a neglected entity-state of the art.” RMD open vol. 6,1 (2020): e001136. doi:10.1136/rmdopen-2019-001136
Gill, Tejpal, et al. “The intestinal microbiome in spondyloarthritis.” Current opinion in rheumatology vol. 27,4 (2015): 319-25. doi:10.1097/BOR.0000000000000187
Rosenbaum, James T. “The eye in spondyloarthritis✰.” Seminars in arthritis and rheumatism vol. 49,3S (2019): S29-S31. doi:10.1016/j.semarthrit.2019.09.014
Seo, Mi Ryoung et al. “Delayed diagnosis is linked to worse outcomes and unfavorable treatment responses in patients with axial spondyloarthritis.” Clinical rheumatology vol. 34,8 (2015): 1397-405. doi:10.1007/s10067-014-2768-y
Sharip, Aigul, and Jeannette Kunz. “Understanding the Pathogenesis of Spondyloarthritis.” Biomolecules vol. 10,10 1461. 20 Oct. 2020, doi:10.3390/biom10101461
Spinal stenosis is when space somewhere along or within the spine begins to narrow, closing off the ability of normal/comfortable movement and nerve circulation. It can affect different areas, including the cervical/neck, lumbar/low back, and, less commonly, the thoracic/upper or mid-back regions causing tingling, numbness, cramping, pain, muscle weakness, or a combination in the back, leg/s, thighs, and buttocks. There can be various factors causing the stenosis; correct diagnosing is the first step, and where a spinal stenosis MRI comes in.
Spinal Stenosis MRI
Stenosis can be challenging to diagnose as it is more of a symptom/complication than a condition, often caused by herniated discs, bone spurs, a congenital condition, post-surgery, or after an infection. Magnetic resonance imaging/MRI is a common test used in diagnosis.
Diagnosis
A healthcare professional, like a chiropractor, physical therapist, spine specialist, or physician, will begin with understanding symptoms and medical history.
A physical exam will be conducted to learn more about the location, duration, positions, or activities that decrease or worsen the symptoms.
Additional tests include muscle strength, gain analysis, and balance testing to help better understand where the pain is coming from.
To confirm a diagnosis, imaging will be required to see what is going on.
An MRI uses computer-generated imaging to produce images that show bone and soft tissues, like muscles, nerves, and tendons, and if they are compressed or irritated.
A healthcare professional and MRI technician will go over the safety requirements before the imaging.
Because the machine uses powerful magnets, there can be no metal on or in the body, like implanted prostheses or devices that include:
A different imaging test may be used if an individual cannot have an MRI like a CT scan.
An MRI can range from several minutes to an hour or longer, depending on how many positions are necessary to isolate the injured area and get a clear image. The test is painless, but sometimes individuals are asked to maintain a specific position that could be uncomfortable. The technician/s will ask if there is discomfort and offer any help to make the experience as easy as possible.
Treatment
Not all cases of stenosis cause symptoms, but there are treatment options that a healthcare professional can recommend.
Conservative care is the first recommendation that includes chiropractic, decompression, traction, and physical therapy.
Treatment increases muscle strength, improves range of motion, improves posture and balance, decreases discomfort symptoms, and incorporates strategies to prevent and manage symptoms.
Prescription medications could be part of a larger treatment plan.
Surgery could become an option in more severe cases where conservative care is not working.
Spinal Stenosis
References
Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. Diagnosis of lumbar spinal stenosis: an updated systematic review of the accuracy of diagnostic tests. 2013. Available from: www.ncbi.nlm.nih.gov/books/NBK142906/
Ghadimi M, Sapra A. Magnetic Resonance Imaging Contraindications. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK551669/
Gofur EM, Singh P. Anatomy, Back, Vertebral Canal Blood Supply. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK541083/
Lurie, Jon, and Christy Tomkins-Lane. “Management of lumbar spinal stenosis.” BMJ (Clinical research ed.) vol. 352 h6234. 4 Jan. 2016, doi:10.1136/bmj.h6234
Stuber, Kent, et al. “Chiropractic treatment of lumbar spinal stenosis: a review of the literature.” Journal of chiropractic medicine vol. 8,2 (2009): 77-85. doi:10.1016/j.jcm.2009.02.001
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