What is Spinal Stenosis?
A narrowing of the spinal canal in the backbone, through which the spinal cord passes, is called as spinal stenosis. As the spinal canal narrows down it starts exerting pressure on the spinal nerves. This can cause a variety of problems including pain and numbness in the areas supplied by the spinal nerve affected.
The spinal cord originates from the brain stem and moves downward through the spinal canal to the lumbar region. As it goes down it sends out spinal nerves that innervate various parts of the body. Spinal nerves have both sensory and motor functions. Thus they transmit signals from various parts of the body to the brain and vice versa.
Spinal canal is a hollow space that runs inside the vertebral column. Vertebrae are bony structures that have a central hollow and various prominences and foraminae or openings around it. They lie on top of each other in a systematic manner to form the backbone or vertebral column.
There are a total of thirty three vertebrae. Of these twenty four are separated from each other through intervertebral discs and the rest are fused. The vertebra is classified according to their position in the spine. There are seven cervical, twelve thoracic and five lumbar vertebrae separated by intervertebral discs. The remaining nine in the sacrum and coccyx are fused together.
The vertebrae separated by the intervertebral discs are also called as articulating vertebrae. The lower portion of a vertebra rests on a groove on the upper portion of the vertebrae below it. The size of the spinal canal is uniform in all vertebrae. The spinal cord passes freely through the vertebrae without any obstruction. The spinal nerves exit through the vertebral foramina in all vertebrae.
As a person ages there will be an associated wear and tear in the bones of the body. There can be degenerative or inflammatory changes in the bones including the vertebrae. There can also be degeneration of the intervertebral discs that acts as a cushion between the vertebrae. These changes can cause the vertebrae to move from its original position and create bone spurs in the spinal canal. These and other factors combine together to create stenosis or narrowing of spinal canal.
Spinal stenosis symptoms:
The symptoms of spinal stenosis depend on the area affected. The symptoms of cervical and lumbar spinal stenosis may vary. The intensity of the symptoms depends upon the degree of stenosis.
The symptoms of cervical spinal stenosis are:
• Numbness of a hand, leg or foot
• Tingling sensation on the affected area
• Weakness of the affected area
• Problems with walking
• Balancing problems
• Neck pain
• Bowel or bladder dysfunction
The symptoms of lumbar spinal stenosis are:
• Numbness or tingling sensation of the affected leg
• Weakness of the affected leg
• Low back pain
• Cramps in the affected leg
Spinal stenosis causes:
There are a number of causes for spinal stenosis. They are all related to the degeneration of the vertebrae and intervertebral discs. Some of the common causes are
• Formation of bone spurs due to osteoarthritis
• Herniation of disc or slipped disc
• Thickening of intervertebral ligaments
• Tumours of the spinal cord
• Traumatic injuries of the spine
Spinal stenosis treatment:
The treatment for spinal stenosis depends on the intensity of symptoms. The common treatments for spinal stenosis are given below:
• Medications- Pain relievers are the first mode of treatment. The goal of treatment is to control pain. Opiod analgesics are also used in certain situations. Steroid injections are also given to reduce the symptoms.
• Physical therapy- Certain therapeutic exercises are prescribed to strengthen the spine and to make it flexible.
• Surgery - Surgery is recommended if the symptoms are severe in nature. The common surgical procedures are
Laminectomy-A decompression surgery where the back portion or the lamina of the vertebrae is removed.
Laminotomy-This procedure intends to relieve the pressure on the nerves by removing a portion of the lamina.
Laminoplasty- A surgery to reshape the lamina.
Spinal fusion surgery- The surgery is done to improve the stability of the spine
Ayurvedic treatment for spinal stenosis:
Ayurveda is an ancient Indian system of medicine. According to Ayurveda, our body is composed of five elements namely earth, water, fire air and space. These five elements or ‘panchabhutas’ according to Ayurveda combine in a unique manner to make up an individual’s body constitution. The panchabhutas manifest in the body as three doshas or humors namely vata, pitta and kapha. An individual’s body constitution is referred to as ‘prakrithi’ or inner nature.
There is a normal equilibrium of the three doshas in our body that helps us in a state of ‘sukha’ or good health. Any change in this equilibrium can create disturbances in the body and cause ‘asukha 'or illness. Illnesses can occur due to an aggravation of a particular dosha or a depletion of another. The aggravation of any dosha can create various toxins or ‘ama’. The principle followed by Ayurveda for treating an illness is to restore the harmonious equilibrium of the three doshas. The restoration of the equilibrium gets rid of the illness.
Spinal stenosis according to Ayurveda occurs due to an aggravation of the vata dosha. An aggravated state of vata causes degeneration of various body parts especially the bone. This degeneration of the bone can cause various disturbances .Spinal stenosis occurs due to the degeneration of the vertebrae that make the spine. The degeneration occurs as already said to the aggravation of the vata dosha.
The aim of ayurvedic treatment for spinal stenosis is to restore the vata dosha to the normal levels. Ayurveda prescribes treatments like panchakarma, oral medications as well as medicines for local application.
Panchakarma is a five- fold therapy aimed at cleansing the body. The various treatments in panchakarma are:
• Vamana- A treatment where emesis or vomiting is induced through treatment. This helps to get rid of the accumulated toxins in the body systems.
• Virechan- In this procedure purgation is the way to get rid of toxins.
• Vasti- In this treatment medicated enema is performed to get rid of the toxins.
• Nasya- Nasal drops are administered for cleansing the head and neck region.
• Rakthhamokshana- A therapeutic cleansing of the blood with the aid of medications and massages.
Various other ayurvedic therapies are also done for spinal stenosis. The treatments may vary according to the constitution of the patient. Ayurveda also prescribes a strict dietary regimen or ‘pathya’ as part of the treatment. Certain foods that aggravate the vata dosha are to be avoided. Foods that restore the dosha to normal levels are to be included in the diet.
Duration and cost of ayurvedic treatment for spinal stenosis:
The duration of treatment would be 21-29 days in hospital and would cost around 1300 to 3800 USD.