Spinal stenosis is a narrowing of the spaces inside the spine that puts pressure on the spinal cord or nerve roots, causing back or neck pain and numbness or weakness in the legs or arms. At Advanced Physical Medicine in St. Clair Shores, Michigan, we treat it without surgery using epidural injections, physical therapy and, when needed, spinal cord stimulation.
Stenosis develops slowly, and many people have it on an MRI without any symptoms. When it does cause problems, the signs depend on where the narrowing is.
In the lower back (lumbar stenosis):
In the neck (cervical stenosis):
Central canal stenosis means the main canal holding the spinal cord or nerves has narrowed. Foraminal stenosis means the openings where single nerve roots leave the spine have narrowed. Common causes include:
Lumbar spinal stenosis is most common in people over 50.
Dr. Stephen Wilson, MD, is double board-certified in Physical Medicine & Rehabilitation and Pain Medicine and has more than 25 years of experience treating pain. We review your imaging, examine your strength, reflexes and walking, and may perform an EMG and nerve conduction study in our office to see which nerves are affected. Non-surgical options include:
An epidural steroid injection places anti-inflammatory medication near the irritated nerves to ease leg or arm pain. Facet and nerve root injections are also available. See our interventional procedures.
Physical therapy builds core and hip strength, improves posture and uses flexion-based exercises that open the spinal canal, so you can walk and stand longer.
For leg pain that has not improved with other care, spinal cord stimulation may help. You try it during a short trial before deciding on a permanent device.
MLS laser therapy, medical acupuncture and other holistic pain relief options can reduce pain alongside a full pain management plan.
Book a visit if back or leg pain limits how far you can walk or stand, if numbness or tingling in the legs or hands keeps coming back, or if pain has lasted more than a few weeks. Many people with stenosis do well with non-surgical care, and we will refer you to a spine surgeon if your exam or imaging shows that surgery should be considered.
Get emergency care for new loss of bladder or bowel control, numbness in the groin or inner thighs, or rapidly worsening weakness in the legs.
A physical medicine and rehabilitation or pain medicine physician is a good first stop for non-surgical care. Dr. Wilson is double board-certified in both. A spine surgeon is consulted when surgery may be needed.
There is no single best treatment for everyone. Most people start with physical therapy, activity changes and, when needed, epidural injections. Surgery is considered when symptoms are severe or keep getting worse.
Short walks with rests, a stationary bike, leaning forward when standing, keeping a healthy weight and the exercises from your therapist all help. Ask a doctor before taking anti-inflammatory medicines regularly.
It is narrowing of the main canal in the middle of the spine that holds the spinal cord or the bundle of nerves below it. It can affect both legs, while narrowing at the side openings usually affects one nerve.
It is common, especially after age 50, because the changes that cause it come with normal aging of the spine. Many people with narrowing on an MRI have few or no symptoms.
Advanced Physical Medicine accepts most major insurance plans. Some treatments, such as regenerative injections, may be self-pay, and our staff will go over coverage and costs with you before you start.
Book a visit with Advanced Physical Medicine at 24345 Harper Ave, St. Clair Shores, Michigan, or call us at (586) 563-3300. We will find out what is behind your spinal stenosis and talk you through every option before anything is decided.
