Sciatica Due To Spinal Stenosis
Sciatica due to spinal stenosis is less common that sciatica due to disc herniation (which I discussed in the previous article), however, it is the most common cause of sciatica in individuals over 60. So this will be the topic of this article – the second of our three part series on sciatica.
Here are the key topics I will cover…
- How the spine develops arthritis and degenerative changes
- How Spinal Stenosis leads to Sciatica Pain
- The best Treatment Options for Spinal Stenosis and Sciatica – Including a review of Cox Technique
Spinal Arthritis and Degenerative Changes
The spine consists of a series of spinal bones stacked together to form a movable column. As the vertebrae join together they do so in such a way that the openings at the centre of each vertebrae line up to form the spinal canal, a long channel that runs down the centre of the spine and houses the spinal cord.
As the spinal cord descends within this canal it gives off nerve branches that exit the spine through small holes known as intervertebral foramen located on either side of the spine. In the case of the lumbar spine these nerve roots will come together to form the sciatic nerve, which then travels down the back of the leg.
Under normal circumstances there is enough space within the spinal canal and intervertebral foramen for the spinal cord and exiting nerve branches. However, as we age the bones of the spine can become arthritic and begin to breakdown.
This arthritis is caused by excessive or abnormal stress to the joints of the spine that occurs over a long period of time (which is why sciatica due to spinal stenosis is more evident in individuals over 60). This abnormal stress will lead to formation of new bone known as bone spurs or osteophytes.
While these arthritic changes can lead to pain, stiffness, and inflammation in the back, the bigger problem is that in more advanced cases these osteophytes can take up space in the spinal canal or intervertebral foramen and begin to pinch or compress the nerve roots as they exit the spine.
The pinching or compression can lead to damage and irritation of the exiting nerves and with it sciatica symptoms such as pain, burning, numbness, and sometimes muscle weakness into the leg.
Treatment For Sciatica Due To Spinal Stenosis
Fortunately, very few sciatica cases require surgery, with most patients responding well to the right type of conservative treatment. However, given the pain and potential for long term and even permanent neurological deficits, these conditions need to be diagnosed and managed properly.
The first priority in treating these cases is to reduce the pressure on the compressed and irritated nerve roots so they can start to heal and get the pain under control – this usually requires a combination of specific in-office treatment, along with special home-based exercises.
In our office we use a treatment method known as Cox Flexion-Distraction. We have published other articles that demonstrate this treatment in detail, but for the sake of continuity I will provided a brief description here as well.
Cox Therapy for Sciatica Due to Spinal Stenosis
Cox treatment uses a specially engineered table that gently pulls and stretches the spine. With the patient lying on the table, the lower section of the table can be slowly pulled down and away. This motion lengthens the spine, which pulls the bones of the spine away from each other and acts to “decompress” the compressed nerve root.
Unlike other traction or decompression therapies, with this treatment we are able to focus the stretching and decompression effect at the specific areas of the spine that are damaged.
Not only does this open the joints of the spine and take pressure off of the pinched and compressed nerve roots, but this procedure also acts to stretch the muscles and ligaments of the spine. This helps to reposition the vertebrae in a way that increases the size of the spinal canal and intervertebral foramen, creating more space of the spinal cord and nerve roots.
Exercises for Sciatica Due to Spinal Stenosis
In addition to using Cox technique, we also prescribe specific exercises to help manage pain and stimulate healing of the inflamed nerve root and spine. These exercises are a critical part of treatment as the patient can do them several times a day as opposed to only receiving in office treatment a few times per week.
We have found that combining Cox Treatment with these home based nerve and spine based exercised we are able to help most sciatic patients get out of pain and get back doing the things they want and need to do, with dramatic improvement coming in just a few weeks.
Get Relief with Cox Technique
To learn more, or to book an appointment to see if Cox Flexion-Distraction will be able to help with your spinal stenosis problem simply call our office at (905) 685-7227. Or you can book an initial assessment using our online scheduling system.
Related Videos: See How Cox Flexion Distraction Works