In our last blog we discussed spinal stenosis, so this time we’ll be tackling another common form of stenosis – lateral recess stenosis.
This condition refers to when compression occurs at the junction point of the spinal cord and nerve root – the spot where the nerve root branches off the spinal cord is referred to as the lateral recess (hence the name!). When this area becomes compressed (commonly the low back/lumbar spine or neck/cervical spine) the nerve becomes trapped.
Lateral stenosis also occurs on one side of the spine – it is very rare to have both sides involved.
So how does this happen?
Often affecting those who are middle-aged and upwards, it can be common for another condition to occur along with and be the cause of lateral stenosis. These conditions may include:
- Bone spurs
- Bulging discs
- Degenerative disc disease
- Herniated discs
- Facet joint disease
Can you explain more?
As we age our discs age, they dry out, lose height and are more prone to bulge or herniate. Our discs have a harder outside (annulus) and soft jelly-like inside (nucleus). As we age or injure our spines, small cracks can appear in the annulus, and further damage can allow the nucleus to push through the cracks and out into the lateral recess. This is called a disc herniation.
Osteoarthritis and facet joint disease are conditions wherein our discs loose height and the vertebrae get closer together along with the facet joints. Over time the cartilage gets worn away and the facets result in bone on bone. This stimulates extra bony growths or spurs to form which can then cause the narrowing (stenosis) and encroachment onto the nerve. Inflammation in the early stages of this process can also put pressure on the exiting spinal nerve.
Finally, spondylolisthesis is where one vertebra slips forward onto another, so the ‘tunnel’ shape becomes distorted and end up pinching the exiting nerve.
What are the symptoms?
Symptoms of lateral recess stenosis to no surprise are indeed similar to spinal stenosis. Pain, weakness, and discomfort will gradually grow over time.
In the lumbar spine one of the most common issues is sciatica, which is the feeling of pain radiating down the back of the leg into the ankle. This may be accompanied by pins and needles and numbness in the feet and toes. Muscle wasting may also occur – a classic sign of this is where the foot drops and cannot be lifted when walking.
Can it be treated?
Treatments for lateral recess stenosis include exercises, hot and cold therapy, anti-inflammatory medications, and supports such as back braces. These are easy, at home remedies to help you say goodbye to your pain from narrowing of the spine.
As osteopaths we see this problem daily. Osteopathic treatment helps improve spinal mobility and increase movement in order to help disperse the inflammation. The muscles can often become very tense and tight and can add to the pain, which can be eased by soft tissue massage and stretching.
If conservative treatment fails, then more invasive procedures can be considered such as spinal injections or surgery – of course, we advise speaking with your doctor about the many different options to help determine which is the right one for your condition!
Still have questions about what lateral stenosis is? Give us a call on 01722 512 043 or click here to book yourself an appointment with one of our expert osteopaths.