Stenosis is a narrowing of the vertebral canal or the lateral intervertebral canal (located in between two vertebraes). In other words, it can be a central stenosis (which has a greater impact on the spinal cord) versus lateral stenosis (better prognostic) or it can only be the nerve root coming off the spinal cord that can be affected along its specific trajectory of innervation.
Series of minor traumas, especially when not properly treated, explain the beginning of degenerative changes in the spine. These incidents add up over the years and eventually become persistent problems of spondylosis (spinal osteoarthritis) or spondylolysis (defect or stress fracture in the vertebral arch) leading to mechanical musculoskeletal symptoms i.e. muscle weakness, ankylosis or hypermobility at a particular spinal segment.
Following a disc herniation, an inflammation of a facet joint capsule, or a cartilaginous damage, the joint will loose height and will result in decreased stability. We also sometimes see osteophytes (bone spurs) form within the joint, which compress and irritate the nerve. The nerve occupies around one third of intervertebral foramen, therefore if there is loss of disc height and osteophytes present in that small space, there is a higher chance of nerve compression. Prevention or early intervention can avoid possible lesions and promote a faster return to function.
Let’s discuss treatment options. After an extensive subjective evaluation of the condition, taking into consideration the motif of consultation and the past medical history, your physiotherapist will perform all the necessary tests to have a better understanding of the injury and in order to develop a proper personalized treatment plan. The physiotherapist will take note of the articular mobility, the passive tissues stability (capsules, ligaments and fascias), the muscular strength and the neurological signs to determine whether the problem is of musculoskeletal in origin. It is the physiotherapist’s responsibility to direct the patient towards a doctor if there is presence of any red flags, signs that suggest the need for medical or surgical interventions.
Your physiotherapist will use different treatment approaches. For example, manual therapy, muscular and myofascial release, pain modalities and exercise prescription. The treatments will aim to eliminate the pressure on the nerve root using “opening or flexion” techniques of your spine. Consequentially, with a reduction in nerve root pressure, there will be a decrease in inflammation and pain. Furthermore, you will receive an exercise program in order to maintain the proper mobility of your spine and prevent future low back pain episodes.
Stop suffering from low back pain, consult your physiotherapist!