Why are your hand and arm numb?
After getting out of bed, your neck is hurting, and your right arm feels tingling and slightly weak. You figure you slept wrong and go about your routine. Your symptoms don’t get any better. In fact, they start to get worse. The doctor diagnoses you with spinal stenosis. What is that? How is it treated?
Definition
Spinal stenosis is when the spaces within your spine narrow. This puts pressure on the nerves. It often occurs either in the neck (cervical stenosis) or lower back (lumbar stenosis). The latter is more common. There are several causes of spinal stenosis. One is the overgrowth of bones, which is usually the result of wear and tear on your spinal bones, causing bone spurs that grow into the spinal canal. Another common reason is herniated discs. The spinal discs are supposed to act as shock absorbers between your vertebrae. As you age, they dry out, causing cracks in them that can lead to some of the soft inner material escaping and pressing on the spinal cord or nerves. The ligaments that help hold your spine together can become thick and stiff over time; the result is them bulging into your spinal canal. If you have a spinal injury, it can cause damage that results in pressure being placed on your spinal nerves. A less common issue is a tumor somewhere in your spine, putting pressure on the nerves.
Symptoms depend on the location of the stenosis. For cervical stenosis, individuals often have numbness/tingling in a hand/arm/foot/leg, weakness in a hand/arm/foot/leg, problems with walking and balance, neck pain, and bowel/bladder dysfunction (urinary urgency and incontinence) in severe cases. Those with lumbar stenosis, they’ll have numbness/tingling in a foot/leg, weakness in a foot/leg, pain/cramping in one or both legs when standing/walking for long periods (usually eases when you bend forward or sit), and back pain. If not treated, spinal stenosis can cause permanent numbness, weakness, balance problems, incontinence, and paralysis.
Treatment
Spinal stenosis treatment depends on the location it occurs and the severity of your symptoms. For mild cases, your doctor will recommend monitoring your condition with regular follow-ups. When it comes to medications, the initial choice is over-the-counter pain relievers, like ibuprofen, naproxen, and acetaminophen. If these don’t work, your doctor will try tricyclic antidepressants because they’ve been shown to decrease chronic pain or certain anti-seizure drugs because they’ve been proven to reduce the pain caused by damaged nerves. If your pain is severe, your doctor might suggest a short course of opioid pain relievers.
Besides medications, your doctor will want you to try using heat and cold therapy. Cold therapy helps to reduce the pain, while heat aids in decreasing inflammation. Your doctor will also recommend doing stretching exercises or yoga. Another option is to go to physical therapy. Most people with spinal stenosis avoid activities because they don’t want to hurt, but eventually, this leads to muscle weakness, which increases pain. A physical therapist can help you build up your strength and endurance, improve your balance, and maintain the flexibility and stability of your spine.
Some individuals benefit from steroid injections to the nerve root area, which becomes irritated and swollen when they’re pinched. Injections of corticosteroids around this area reduce inflammation, thereby relieving pain. It’s important to note that this won’t fix your stenosis. Also, repeated injections of steroids can weaken nearby bones and connective tissue, so you can only get these injections a few times a year.
For individuals with thickened ligaments, your doctor can perform a decompression procedure. This involves removing a portion of the thickened ligament. This can only be done for those with lumbar stenosis. There are other surgical options available. A laminectomy involves the removal of the back part (lamina) of the affected vertebra. Sometimes, that vertebra is linked to adjoining vertebrae with metal hardware and a bone graft (spinal fusion) to maintain the spine’s strength. With a laminotomy, only a portion of the lamina is removed, typically carving a hole just big enough to relieve the pressure in a particular spot. A laminoplasty is performed only on the vertebrae in the neck. During the procedure, the surgeon opens up space within the spinal canal by creating a hinge on the lamina. Metal hardware connects the gap in the opened section. It’s essential to note that while most people have relief after these procedures, some people’s pain actually gets worse.
Prevention
Maintaining a healthy lifestyle from the time you’re young is vital to having good back health when you’re older. This can lower the possibility of having spinal stenosis. One of the most important things is getting regular exercise that not only promotes improved circulation and muscle strength but also encourages flexibility. Also, eating healthy is vital because it’ll decrease the probability of being overweight, which adds to the stress on your back.
Spinal stenosis can have a considerable impact on your life. However, with the proper treatment, you can have your life back. If you have any questions or concerns about spinal stenosis, please speak with your doctor. If you would like more information, please visit Spine Health’s Spinal Stenosis page at https://www.spine-health.com/conditions/spinal-stenosis/what-spinal-stenosis