By Dr. Jonathan Chung
Spinal stenosis – when the name is sometimes worse than the problem
Main causes of spinal stenosis
Is chiropractic safe for patients with stenosis?
There are thousands of people every year with neck pain or back pain that go to a doctor’s office, get an MRI, and end up with a diagnosis of spinal stenosis.
If you happen to be one of these patients, I can understand your fears and concerns. After 2 years in my Wellington, FL office, we’ve had the opportunity to take care of dozens of patients with stenosis in their neck and lower back.
Many times you went to the doctor because you have excruciating pain that is limiting your ability to live or work. You go and get an MRI which means the doctor is potentially looking for something seriously wrong, and when the results come back you get a diagnosis that sounds a little scary.
Spinal stenosis is actually a relatively vague diagnosis. It literally means that the hole that surrounds your spinal cord has gotten smaller. Small hole in the spine disease doesn’t sound quite as scary as spinal stenosis does it?
Now I don’t want to downplay the seriousness of the problem, because there are certainly some very serious cases that are emergencies and require immediate surgery. We’ll talk about those emergency cases later.
What I do want to do is to have you take back power from your diagnosis, because your case of stenosis may be serious, and may not even be the source of pain. The truth is that a large number of spinal stenosis cases can be managed conservatively. Many cases of spinal stenosis cause no symptoms at all which is a good reminder that you are not your MRI nor your diagnosis.
My Favorite Spinal Stenosis Story:
This article helped me remember a patient I took care of a few years ago. The man had spinal stenosis, and like many people with spinal stenosis, they may walk around with an assistance device like a cane. Now this guy didn’t have an ordinary cane, he had a really intricate one like the one from this picture. One that you remember if you see it.
The patient and his wife were snowbirds so I only had a limited amount of time to work with them, about 3 weeks if I remember correctly.
The reason I remember this story is because he was really proud of his cane when he first started. He loved talking about it and sharing the story behind it. However, after a short period of time, he actually stopped bringing it into the office with him because he stopped needing it.
While he’s very proud of the cane and where it came from, he was even more proud to have the ability to walk like a normal human being again.
What Makes the Hole Smaller?
There are a number of things that can cause spinal canal stenosis. Remember that spinal stenosis is just a term that means the hole in the spine is shrinking, so we have to know what’s causing it to get smaller. These are the main things:
Large disc herniations • Bone spurs/ligament growths
Fractures/dislocations • Tumors
As you can see, there are some pretty serious things on this list. Fractures, dislocations, and tumors are not anything to mess around with, but they are the minority in terms of spinal stenosis.
Large disc herniations and bone spurs make up the large majority of cases. While disc herniations and spurs can be serious in some cases, they can also cause no symptoms what so ever. It really depends on if the spinal cord or spinal nerves are being affected by these obstructions.
Can Chiropractic Help? Is Chiropractic Safe?
When I first started in practice, I remember how frequently people used to tell me
“Oh, I wish I could see you, but I have spinal stenosis and my doctor said chiropractic could paralyze me”
On one hand, we know that spinal manipulation utilized in the wrong place and the wrong time can be unsafe. However, there’s very little reports in scientific journals that are showing that patients with spinal stenosis are getting injured by chiropractors. It’s even more significant when you consider that many patients with spinal stenosis are showing up in chiropractic offices because of the severity of their neck and back symptoms.
Ultimately, we do have to recognize that gross spinal manipulation on a spine with stenosis can have risks. Putting a lot of force into a spine that has narrowing around the spinal cord could potentially worsen or aggravate the condition.
In these times, it’s important to remember that not all chiropractic techniques are the same. Most chiropractors are trained in multiple methods to address the spine. While one may predominate over the other, we often must modify our techniques depending on if a patient has severe osteoporosis or if their spine is fused together from surgery.
When great care is taken to be precise and gentle with the delivery of an adjustment, then patients with spinal stenosis can often times be our biggest fans.
When it comes to Structural Correction, we utilize highly detailed imaging, analysis, and corrective procedures so that there’s no risk of jarring the narrowed spinal structures into the spinal cord.
How Structural Correction Can Help
Many cases of spinal stenosis are a result of the spine degenerating over time. This breakdown can be initiated and accelerated by a body out of balance.
By balance, I don’t mean this vague, esoteric term without meaning. I literally mean that the positioning of the shoulders and hips cause the spine to bear weight abnormally.
When someone receives a precise Atlas Correction, the structure of the spine can improve leading to a potential reduction in the forces that create wear and tear associated with spinal stenosis.
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