Spinal Stenosis; Have you considered chiropractic care as an effective option?
The patient has been having leg and back pain for many years and now the pain seems to be constant. They are typically in their 70’s or 80’s and after many medical tests and failed treatment options, the patient has an MRI with a diagnosis of moderate to severe spinal stenosis. How did we get here and what are the treatment options?
First, you need to understand what spinal stenosis is. Wikipedia has a good explanation. They state the following
“Spinal stenosis is an abnormal narrowing (stenosis) of the spinal canal that may occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit. Symptoms include pain, numbness, paraesthesia, and loss of motor control. The location of the stenosis determines which area of the body is affected. With spinal stenosis, the spinal canal is narrowed at the vertebral canal, which is a foramen between the vertebrae where the spinal cord (in the cervical or thoracic spine) or nerve roots (in the lumbar spine) pass through. There are several types of spinal stenosis, with lumbar stenosis and cervical stenosis being the most frequent. While lumbar spinal stenosis is more common, cervical spinal stenosis is more dangerous because it involves compression of the spinal cord whereas the lumbar spinal stenosis involves compression of the cauda equina.” Read more here
When you are diagnosed with spinal stenosis, you are often shuffled from specialist to specialist, and the road often leads to surgery or invasive procedures to open up the spinal canal. Most people who have developed this condition have had problems for years, but learned to live with it. When you are diagnosed, there is no shortage of people selling procedures and therapies. The question is; which ones are likely to work?
One very effective option that is often not offered by many medical specialists is to see a chiropractor. There is more to those symptoms than just the stenosis and the question always is, how did the condition get this bad in the first place? Is it a normal part of aging? If it is a normal part of aging, shouldn’t everyone be suffering from it?
One problem is that most healthcare providers are thought to think disease, rather than mechanical function. Most providers also only diagnose or work with the painful area, something we have grown to expect. What if, the painful area is not why all these symptoms are present? This is the reason you should consider a chiropractor first.
Chiropractors, by their nature are holistic, meaning they look at the entire body, not just where you hurt. Diagnosing a problem by looking at how your body functions mechanically often offers relief where other more aggressive methods fail miserably because you cannot diagnose the condition by an MRI without doing a complete musculoskeletal and gait (how you walk) evaluation. Medication, or steroid injection (http://www.nytimes.com/2014/07/03/health/treatment-for-back-pain-provides-little-help-study.html?ref=health&_r=0) which is popular, but expensive and largely ineffective or even physical therapy exercise regimens may only offer temporary relief if they are working on the symptom, rather than the problem.
Other symptoms such as ankle, knee, hip, lower and upper back pain and stiffness must be considered during your initial evaluation, since they often are clues as to why you are in pain. Many of these symptoms may have occurred over the years, yet, are likely ignored since a diagnosis of stenosis may not seem to have any relationship to the problem. How many times does your doctor treat knee, hip and back problems as separate conditions, even though they are parts of a series of joints that function or malfunction together? Do you really have all these problems too or is this just a gait related problem, with stenosis being the result of years of poor body mechanics that have largely been misunderstood?
What is the chiropractic approach?
In our office, we use an active evaluation approach, testing the body and seeing how you do against the forces of daily living like for instance, can you get out of a chair, or do you need to hold on to something to crouch down? These simple tasks offer clues as to how your body has been functioning and the methods we need to use to improve the condition.
Once we understand mechanically, why the pain exists, most chiropractors use either manual manipulation of the lower and upper body spinal and extremity joints to improve mobility of the person suffering from the problem. Manipulation alone is not effective without muscle techniques such as myofascial release or graston to improve the way the myofascial (connective tissue that surrounds the muscles) works. Then exercises, once we see the patient can function better against the forces of gravity using additional active tests are used to strengthen and retrain deconditioned muscles.
Our approach is not just simply trying things to see if they work. During a typical visit, we use the treat test treat protocol which determines the most cost effective care path to help get the patient back to health quickly.
What may determine success is the level of stenosis that exists. Chiropractors are trained to differentially diagnose which patients are most likely to succeed. Considering the cost of MRI’s and other tests, often plain x rays can help determine the extent of the damage and a trial of care is tried if deemed appropriate. If a patient improves 50% over a short term of care, the cost of an MRI can usually be avoided and in many cases, the cost of care can cost less than the MRI itself. If not, an MRI is a diagnostic tool that can be quite helpful in diagnosing the condition properly. Chiropractors will also consider the neck region itself, since severe stenosis in the neck will result in lower body symptoms.
Spinal Stenosis can be a frustrating condition, usually seen with aging adults. Choosing chiropractic first as your primary spine physician is often a wise, and cost effective choice for getting the best evaluation, care or referral for the condition.