The talented physicians of Long Island Spine Rehabilitation Medicine have a strong track record of treating the debilitating symptoms of spinal stenosis without surgery. Spinal stenosis is a common condition in which the spinal column narrows, putting pressure on the nerves that travel within its confines. Most frequently caused by osteoarthritis associated with aging, spinal stenosis typically occurs in patients over the age of 50. We should also highlight that many thousands of people have spinal stenosis and don’t know it. This is why it is extremely important to treat the patient with stenosis and not just the MRI which reveals stenosis.
There are two types of stenosis: lumbar stenosis (in the lower back) and cervical stenosis (in the neck); of the two, lumbar stenosis is the more common. While many doctors immediately recommend surgery to alleviate the painful and disabling symptoms of spinal stenosis, our doctors are physiatrists who specialize in pain management and rehabilitation. We view surgical intervention as a last resort and have a well-earned reputation for providing our patients with relief and increased function with noninvasive spinal stenosis therapy.
Nonetheless, in severe cases when surgery, such as a laminectomy, discectomy, or spinal fusion, is indicated, we refer the patient to a well-respected surgical colleague. In such situations, we assist patients with postsurgical spinal stenosis physical therapy as they recuperate.
Causes of Spinal Stenosis
Though there are people whose spinal canals are narrow at birth, most cases of spinal stenosis occur due to:
- Herniated discs
- Bone spurs (overgrowths of bone) on the spine
- Ligaments that have thickened over time and protrude into the spinal canal
- Accidental injuries, particularly those that result in spinal fractures
- Spondylolisthesis, slippage of one vertebra over another
- Postsurgical inflammation of tissue adjacent to the spine
Rarely, tumors or other masses within the spinal column may be the cause of spinal stenosis or compression.
Symptoms of Spinal Stenosis
Though it is possible to have spinal stenosis without symptoms, the condition may or may not worsen over time. Depending on the location of the problem and which nerves are impacted, the upper or lower body will be affected. Cervical stenosis affects the arms and hands, while lumbar stenosis affects the legs, buttocks, and feet. Symptoms of spinal stenosis include:
- Pain in the back, neck, limbs or extremities
- Tingling, numbness, and muscle weakness
- Difficulty walking
- Impaired balance
- Muscular weakness
- Leg cramping
- Pain when standing or walking for long periods
- A sense of lack of coordination
In the most severe, untreated cases, spinal stenosis can result in bladder or bowel dysfunction, paralysis, or even death.
Diagnosis of Spinal Stenosis
As experienced physiatrists, we know how important it is to be cautious when making diagnoses. Similar symptoms may have different causes. We, therefore, follow a well-established protocol to determine whether or not you have spinal stenosis and, if so, what its underlying cause is. We do this by performing a full spine and musculoskeletal evaluation, including:
- Complete medical history
- Thorough physical examination
- Review of X-rays
- MRI scan, CT scan
- Electrodiagnostic studies, EMG and nerve conduction studies (NCS)
These steps will help us not only to confirm our suspicions of spinal stenosis but to pinpoint the location, underlying cause, and severity of the condition. If there is any remaining uncertainty concerning your diagnosis, we will perform electrodiagnostic studies that will detect any evidence of nerve damage from ongoing stenosis. Such testing will also help to rule out peripheral neuropathy, a condition that can mimic spinal stenosis.
When you are diagnosed by the physiatrists of Long Island Spine Rehabilitation Medicine, you can have full confidence in the results. Not only do our doctors have a great deal of experience, but they have also completed extensive training in performing these studies. Each physiatrist is either board-certified in electrodiagnostic medicine or board eligible for subspecialty certification in neuromuscular medicine.
Nonsurgical Spinal Stenosis Treatment
At Long Island Spine, we offer several effective treatments for spinal stenosis, treatments that often provide relief from symptoms after a few, or sometimes even one, visit to our office.
Spinal Stenosis Physical Therapy
Many of our spinal stenosis patients benefit from “flexion bias,” or simply putting the body in the position in which it feels most comfortable. If, for example, bending forward relieves your pain, you are taught how to correctly assume that position (and for how long) for spine stabilization. Many other types of physical therapy work to relieve the symptoms of spinal stenosis, such as:
- Exercising to strengthen muscles in the affected area
- Learning to maintain proper posture when lifting, pushing and pulling
- Heat and ice therapy
- Pelvic tilts
Our physical therapists are all certified by the McKenzie Institute and are specially trained to treat spinal disorders like spinal stenosis.
Our physiatrists are deeply concerned with your pain level and realize that, in addition to interfering with your daily routine, pain can prevent you from doing the physical therapy that will help you heal. Most pain can be treated with nonprescription medications, but if you have severe persistent pain, we may prescribe stronger analgesics or anti-inflammatory agents for a short period of time.
We may also prescribe muscle relaxants for pain control, especially to help you sleep comfortably. To keep you safe from drug interactions, we make sure to have detailed knowledge of your present medication (and supplement) regimen.
Spinal Injection Procedures
Another successful method of pain relief for patients suffering from spinal stenosis is the administration of selective transforaminal epidural injections. These injections, administered with fluoroscopic guidance, are designed to target the epidural space surrounding the compressed spinal nerve and, by doing so, to relieve severe leg or back pain.
The injections contain a mixture of a corticosteroid to reduce inflammation and a local anesthetic to reduce pain. Both scientific data and experience with our own patients provide evidence that these injections can succeed in symptom relief even when other methods have failed.
For thousands of years, acupuncture has been used to relieve pain and ease mobility. At Long Island Spine, we use sterile, tiny needles to administer treatment that is relaxing, pain-free, and often provides relief after only a few sessions. Acupuncture works by:
- Stimulating the central nervous system to release of endorphins (natural painkillers)
- Speeding the electromagnetic signals prompt the release of immune system cells
- Changing brain chemistry by releasing neurotransmitters and neurohormones
Acupuncture is designed to correct the flow of energy, known as QI (“chee”) throughout the body, helping to relieve pain and restore health. Acupuncture is provided in our Great Neck and East Meadow offices.
Contact Our Offices For Spinal Stenosis Treatment Without Surgery
Beyond being highly skilled physiatrists, our doctors are caring individuals who prize our patients’ comfort and ease of function above all else. We are dedicated to relieving your pain without the risks, downtime, and possible complications of surgical intervention. At the same time, our physiatrists are acutely aware of when surgery or surgical consultation is or is not indicated. We will always guide our patients in an evidence-based and prudent fashion and work hand in hand with our outstanding surgical colleagues when needed. In all of our five offices throughout Long Island, we have caring, efficient staff, pleasant surroundings, and cutting- edge diagnostic and treatment equipment. Contact us promptly so we can help you heal.