By Dr Danica Newbold, B.HSci (Chiro), M.ClinChiro, Ad.Dip Myo. Certified Cox® Technic Chiropractor and Myotherapist.
Spinal stenosis is the narrowing of the central spinal canal and/or exiting nerve spaces in the spinal column, resulting in compression of critical neurological structures. Spinal stenosis may involve multiple areas or levels throughout the spine. Most commonly, the low back (lumbar spine) and the neck (cervical spine) are the primary sites affected. Spinal stenosis can involve the constriction of the central spinal canal space which houses the spinal cord and traversing nerve roots, but it may also include the spinal foramen openings between the vertebral bones through which the spinal nerve roots exit out towards the periphery. The most common cause of spinal stenosis is the gradual degeneration of the spine. As we age, the human body tends to wear and cause thickening of both soft and hard structures in the body. The spine is not exempt from the degenerative process. The bones and joints of the spine may enlarge due to increased stress causing bone spurs to develop, which encroach on the small spaces within the spine. Spinal stenosis is most common in men and women over the age of 50. However, spinal stenosis may be noted in younger ages groups with congenital spinal narrowing or in those who have sustained an injury to the spine. Spinal stenosis can also be as a result of disc space degeneration, disc bulges or herniations, and spinal cysts that invade the joint and neurological spaces within the spine. While spinal stenosis is not normally cured, owing to its degenerative nature, the painful impact on a patient’s lifestyle may be managed. Realistically, an outcome of a 50% reduction in pain can be achieved, allowing patients to enjoy their daily life. The ability to participate in the activities of daily living is often the desired effect of any treatment for Spinal Stenosis.
Recent research has been published in the Journal of Physical Therapy Science advocating the effects of Flexion-Distraction therapy for Spinal Stenosis patients. It concluded the positive outcome achieved by utilising this therapy model includes:
- Negative pressure generated inside the discal compartment by widening the gap allowing the disc to retreat back centrally (1).
- Reduces back pain associated with spinal stenosis but also the pain associated with severely prolapsed spinal discs and restores function (1).
Further research conducted by the Journal of Clinical Neuroscience demonstrated a study comparing successful versus failed nonoperative treatment approaches in patients with degenerative conditions of the lumbar spine (i.e., Spinal Stenosis). It reported that of the 523, 031 patients involved in the study, 98.3% were successfully treated with conservative management alone (2).
Conservative management for spinal stenosis patients can include spinal mobilization and decompression such as Chiropractic care utilising Cox ® Flexion-Distraction Therapy, and targeted rehabilitation- specifically core strengthening type exercises as prescribed by a practitioner. The Cox® Certified Chiropractors at Malvern Chiropractic and Melbourne Spine Clinic have extensive knowledge and understanding in dealing with chronic conditions such as spinal stenosis. Long-term commitment to spinal care is essential to achieving the desired outcomes of a more pain-free and productive lifestyle, all of which may be obtained under conservative management. Studies have revealed that patients have often seen benefits for individualised treatment and rehabilitation programs and that prescribed exercises improved their overall pain levels and physical limitations (3).
REFERENCES:
- Hyunju Oh, SeokJoo Choi, Sangyong Lee, Kwansub Lee, Jioun Choi: The Effects Of Manual Manipulation Therapy On Pain And Dysfunction In Patients With Lumbar Spinal Stenosis. J Phys Ther Sci 2020;32(8): 499–501
- Mark A Davison, Daniel T Lilly, Jessica Moreno, Carlos Bagley, Owoicho Adogwa: A Comparison Of Successful Versus Failed Nonoperative Treatment Approaches In Patients With Degenerative ConditionsOfTheLumbarSpine. JClinNeurosci2021;86:71‐78
- Bove A, Lynch A, Ammendolia C, Schneider M: Patients’ experience with nonsurgical treatment for lumbar spinal stenosis: a qualitative study. Spine J. 2018 Apr;18(4):639-647. doi: 10.1016/j.spinee.2017.08.254. Epub 2017 Sep 21.
- Image. https://www.mayoclinic.org/diseases-conditions/spinal-stenosis/symptoms-causes/syc-20352961