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In spinal stenosis the structure of the vertebrae changes, causing it to narrow around the spinal cord, applying pressure to the nerves to create discomfort and pain. The usual cause for spinal stenosis is arthritis. As humans age the water content of the intervertebral discs lowers, this reduces their ability to function correctly and the pressure on the vertebrae increases. The vertebrae can begin to become damaged and arthritis is developed. As the cartilage around the bone is worn away the body tries to replace it by producing additional bone. It is this additional bone (bone spurs) which can narrow the space around the spinal cord.
Depending on the severity of the arthritis people with spinal stenosis may suffer from back pain. The stenosis may apply pressure to the sciatic nerve, causing the symptoms associated with sciatica such as pain or numbness in the buttocks and upper legs. In some cases control of the foot may be lost and weakness in the legs may develop.
Non-surgical treatment has been successful in relieving some symptoms of spinal stenosis but cannot alter the change in vertebrae structure. Physiotherapy and anti-inflammatory medicine can help to reduce pain and keep people active. If the person’s quality of life has become very poor, surgery can help to relieve pain and weakness in the back. A laminectomy or ‘decompression’ surgery removes the bone and ligaments which are causing pressure on the nerve. Alternatively if arthritis has progressed to cause spinal instability, the vertebrae can be fused together.