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Spinal stenosis explanation

This spinal stenosis explanation explains how the nerve is trapped.

Spinal stenosis explanation will tell you how your back can cause tingling, pain and weakness in your arms and legs.

This page was last updated by Dr Barrie Lewis on 19th April, 2019..

A narrowing in any part of the spine, mostly the neck or lower back, may stress the spinal cord and cause symptoms and signs in the arms and legs, and even the organs of the body.

The spine gives both support to the body and protection to the spinal cord as it passes to and from the brain to the arms and legs and, of course, the organs. This next patient died of kidney failure, supposedly caused by the pinched nerve.

The spinal cord can be seen here, snugly within the spinal canal, surrounded by bone, ligaments and joints.

Spinal cord and vertebra is a graphic showing how spinal stenosis can cause arm and leg pain and weakness.

Any swelling of the yellow ligament that lies in the spinal canal, or degenerative changes in the facet or disc joints, or a slipped disk, may affect the cord and nerve roots.

In the lower neck, a small appendage called an uncinate process is often injured in a whiplash injury. If untreated they become arthritic invading the foramen and causing pain and tingling in the arm. They form the uncovertebral joints of Luschka.

In the neck the yellow ligament is thin and rarely contributes to spinal stenosis, but in the lumbar area, after long years of chronic low back pain, it becomes thickened and is a major factor in the numbness and tingling in the legs and feet.

Degenerative changes associated with a chronic lumbar or cervical facet syndrome, or slipped disc, and occasionally a childhood fracture in the lower back called a spondylolysthesis are the major contributors to our spinal stenosis explanation.

In our spinal stenosis explanation of the changes in the cervical spine we describe how the symptoms are often worsened by neck flexion.

For example a reflex in the lower leg may diminish on flexing the neck, whereas extension of the cervical spine may affect the arms, cause nerve pain and tingling. 

However, in the lumbar spine, flexion usually relieves the symptoms in the back and legs, and again it is extension that increases the pain and tingling in the lower limbs and back.

The cause, both in the neck and the lower back is usually facet and disc joint related damage due to immobilisation Arthritis.

Read more about how fixated joints cause immobilisation arthritis, the primary cause of spinal stenosis.

Hyaline cartilage

Hyaline cartilage is the most important page at chiropractic help; understanding it is at the heart of this spinal stenosis explanation.

See in this section below, the super-smooth healthy cartilage in a sheep's neck? It's coefficient of friction is lower than ice-on-ice, literally. This enables you to turn your neck freely and without restriction.

Don't underestimate the influence of enjoying anti inflammatory foods in your diet on a daily basis in the prevention of spinal stenosis explanation; many of them also contain flavonoids with proven prevention of malignancies.

  • Kaempferol and cancer prevention

To find links to topics in bold use the site search function in the navigation bar on your left.

However, after trauma, such as in whiplash, a fall from a horse or down a Dutch staircase, the normal flow of synovial fluid carrying oxygen and nutrients to the cartilage is restricted. The result... immobilisation arthritis. The cartilage loses its super-smooth characteristics, becomes pitted and starts forming bony spurs, the first part of the process known as spinal stenosis explanation.

Our mutton stew page has a super low-cholesterol lamb recipe.

One of things you can do for your hyaline cartilage is to make sure it gets plenty of omega-3; fatty fish comes first and foremost to mind. But true free range eggs, if you can find them, have three times as much of this very important fatty acid; kids perform better in school too; but unless the hens have best chicken feed don't expect them to produce these extra nutritional benefits. 

Chiropractic

In the chiropractic profession we believe strongly in the combination of exercise, diet and mobilising fixated joints are at the heart of this spinal stenosis explanation.

Exercise so your don't need to consult your chiropractor twice every week to mobilise your joints; correct diet so the synovial fluids that supply nutrients to the hyaline cartilage are rich in the necessary anti inflammatory substances and adjustments of those subluxated spinal segments.

Hyaline cartilage lining the joints in a mutton chop.

Spinal stenosis explanation

Spinal stenosis explanation outlines how chronic joint fixations cause narrowing of the spinal canal and foramena.

Symptoms of spinal stenosis

Spinal stenosis in the cervical spine can cause cord pressure.

If the narrowing is in the neck then it may affect the legs (and the arms, obviously) as the nerves to the legs must pass through the neck. Thus a weak muscle in the lower leg, due to cervical spinal stenosis could be the underlying cause of a sprained ankle. I have recently had such a case. Referral for a neurological consult confirmed the spinal stenosis, and major spinal surgery actually greatly relieved the man's symptoms and signs.

Tingling in the arms and hands are often the spinal stenosis symptoms associated with degenerative changes in the neck. Read more about SYMPTOMS OF CERVICAL STENOSIS ...

Lumbar spinal stenosis (LSS)

The typical patient is older than 70 years old and has bilateral buttock and/ or leg pain. Typical symptoms are a heavy feeling in the legs, cramps with pain and or numbness. Noteworthy is that there is usually no pain when sitting.

Pain in the low back is relieved by bending forwards, and is worsened dramatically on extension (bending backwards). This is one of the most common signs. To alleviate the pain, the patient often walks in a stooped posture. Femoral Nerve CaseFile; pain in the groin and front of the thigh.

Do you recognise the artist? He's arguably the most famous artist who ever lived. I have just been to the "Complete Rembrandt" in Amsterdam, perhaps the most stunning exhibition I have ever seen. Over a 1000 pieces of Rembrandt. This man is probably suffering from lumbar stenosis.

Reproduction of a Rembrandt sketch of a man with lumbar stenosis.

The pain in the buttocks and/ or legs often is worse with walking, and immediately relieved by sitting, so-called "neurogenic claudication".

It's not that clear in the Rembrandt, but the patient often walks with a broad-based stance, balance is poor and s/he has an abnormal Romberg test.

Spinal stenosis exercises

In order to keep the facet joints healthy they need daily gentle exercise. Every morning, do these simple exercises which allow the facet joints to glide over each other in a non-stressful way. The synovial fluid carrying nutrients and oxygen to the joint is refreshed and any rough bits of the hyaline cartilage are gently polished off.

Walking speed

Interesting 2011 research, reported in JAMA reveals that training yourself to walk faster, and dealing with the problems (like hip arthritis ) that slow you down, will add decades to your life. Quality years, what's more.

  • WALKING SPEED ...

Spondylolysthesis

This is yet another of the causes of sciatica. There are two types of Spondylo-lys-thesis.

One vertebra slides forwards on its nearest neighbour. The first kind is caused by a fracture, usually in childhood, and is often stable. The other caused by severe wear-and-tear of the facet joints is more troublesome often causing lower back and leg pain and contributing to this spinal stenosis explanation.

Tumours

Tumours can mimic the symptoms of spinal stenosis.

Very occasionally spinal stenosis may cause bladder and bowel dysfunction. Such symptoms may also be caused by a tumour lying within the spinal canal; fortunately it's very rare.

Leg length inequality

Leg length inequality and spinal stenosis explanation belong together. A short leg causes increased wear in the hyaline cartilage in the joints.

Leg length inequality causing back pain and ultimately spinal stenosis.

Or in normal jargon, could you have a short leg? Leg length inequality research confirms that a short leg causes not only hip and knee arthritis, but also lower lumbar back pain. It probably ultimately is also one of the causes of lumbar stenosis, and lateral disc herniation, though is unresearched. Leg length inequality and low back pain are now confirmed to be strongly associated.

Not responding to Chiropractic? Has your Chiropractor considered a short leg?

Here is a leg length inequality CaseFile that might interest you, and may just contribute to your spinal stenosis explanation.

Spinal surgery

Spinal surgery usually initially relieves the symptoms of low back and leg pain associated with a slipped disc, but fibrotic changes in and around the nerve may lead to a debilitating sciatica that defies all forms of treatment. Further operations simply further aggravate the complications of surgery resulting in yet more fibrosis and yet another cause of spinal stenosis explanation; Chiropractic treatment may or may not help.

Help for sciatic pain

When I did my training over thirty-five years ago lumbar stenosis was considered a surgical job, and frankly I probably refused to treat it for twenty years. Those were the days before scans and the diagnosis for spinal stenosis explanation was made on the basis of Eisenstein's radiological lines.

But gradually one gains confidence with time and experience in the treatment of more difficult cases. Slipped disc symptoms and signs are no longer a terror in the night to the experienced chiropractor and whilst I would never treat Lumbar stenosis as routine, most patients who are willing to work with me, follow the rules, come for treatment, and do their exercises faithfully respond well.

Only yesterday an elderly lady (83) consulted me for hip pain. Two years ago she first came with severe pain down the front of the leg - in the femoral nerve distribution. When I gave her the spinal stenosis explanation (a degenerative spondylolysthesis) she was flabbergasted and unbelieving: she had been told that only surgery could fix her. Yesterday, she had no back pain, and no pain radiating down the thigh... just a little hip arthritis pain.

If you go the Chiropractic route for treatment for sciatica, a femoral nerve entrapment too, recognise you will have to work at it yourself. Mind you, that's just as true of surgery... it's a rare week that goes by when one is not consulted by a patient who has two, and even three little scars down in the low back. This week a sad message from a patient of a friend who had just died shortly after her fourth back surgery...

We are adding exercises to relieve sciatica and femoral nerve pain to this site. Making good quality films and adding them to the site is technically challenging! We are working at it... LOWER BACK EXERCISES ...

Use the site search function to locate these pages.

Think twice before neck surgery

"I have been living with these symptoms for years. I had surgery on my neck for it 12 years ago, and although it probably kept me from getting worse, I've had to live with neck pain that has been almost crippling - in fact it caused me to leave my 30 year career.

If I had to do it over again, I think I would have put off or avoided having surgery for cervical spinal stenosis because now, not only do I have to live with the annoying and distracting sensations in my legs, I have to live with the neck pain from the surgery."

Magnesium deficiency

Magnesium deficiency and spinal stenosis explanation are certainly connected, and that's why healthy choice foods are so important for everyone. If you're still on the black and white diet, meat and potatoes, you can expect arthritis of the joints. Step up to colour, as in TV.

Spinal stenosis is amongst other things a form of chronic arthritis.

A magnesium deficiency has been identified at being at the root of many cases of arthritis.

Google appears to frown on too many links, so phrases in bold, like those below about spinach, need to be put into the Site Search function in the navigation bar on your left if you want more information.

Spinach is the richest source of magnesium, but take care because 30% is leached out in the cooking. Steam, or use the water to make soups and gravies. Popeye wasn't so dumb after all.

Bernie's healthy spinach dip is one easy way to increase your magnesium and give protection against this form of arthritis.

  • HOW TO GROW SPINACH ...
  • Arm pain radiating from the neck.
  • Leg pain sciatica emanating from the low back.
  • Fish oil benefits for the prevention of spinal degenerative changes.
  • Managing lower back pain is a book by eminent surgeon Dr Kirkaldy-Wallis.


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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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Interesting questions from visitors

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