- What causes spinal stenosis?
- What treatments are most effective?
- What choices do I have?
- Is surgery the best option?
One of the most common explanations for “what causes stenosis?” was described by the Mayo Clinic:
“The main cause of spinal degeneration is osteoarthritis, an arthritic condition that affects the cartilage that cushions the ends of bones in your joints. With time, the cartilage begins to deteriorate and its smooth surface becomes rough. If it wears down completely, bone may rub painfully on bone. In an attempt to repair the damage, your body may produce bony growths called bone spurs. When these form on the facet joints in the spine, they narrow the spinal canal.”
- If spinal stenosis is caused by osteoarthritis, what causes osteoarthritis?
- Common answer is age. But that’s not true because than everyone who’s 60 or 70 would have it and they don’t.
- Genetics is also a popular answer. Again common sense will knock this down because not everyone with the same genetics has osteoarthritis and not everyone with osteoarthritis has the same genes.
- What else could cause it? Let’s think…
- I hear people yelling “accidents and injuries!”
- Oh, good answer, but…and that’s a BIG but…not everyone who’s had the same injuries or who’s been rear-ended develops osteoarthritis.
“With time, the cartilage begins to deteriorate and its smooth surface becomes rough. If it wears down completely…”
Think about it like this: if your front right tire on your car keeps going bald it means your cars alignment is off. If you fix the alignment, that tire will last much longer and not continue to wear out prematurely.
All of us share the same basic design or posture. Since muscles move bones, compromised posture is a muscle problem. Use it or lose it. If we are not reminding our muscles of their job daily, these inactive, atrophied, and compensating muscles will alter the lumbar, thoracic, and cervical curves of our spine and affect the position of our load bearing joints (ankles, knees, hips, shoulders). Pete Egoscue describes how this happens in his book, Pain Free:
The muscles around the spine don’t all go at once. The rate of atrophy depends on the person’s lifestyle and working conditions, but gradually, as the body gets less and less stimulus from the environment, the magical S (curve of the spine) diminishes, taking with it the spine’s flexibility, load-bearing strength, and shock-absorbing capacity.
The standard sugical remedy is to remove the lamina of the vertebrae – basically, one slope of the arch or ridge that runs along the posterior of the spine – enter the canal, and scrape away the calcium.
I have rarely seen a case of stenosis where this procedure was really necessary. Yes, there is calcium in the spinal canal, and there is nerve impingement. But if the lumbar, thoracic, and cervical curves are restored to a functional state, the spinal cord and branching nerve roots usually have enough room to operate without interference.
In this and every circumstance that the body confronts, the old architectural slogan is absolutely right: Form follows function. Reintroduce proper design function, and the form – the structure – isn’t a problem. Back pain, no matter what it is called, is most often a symptom of a breakdown of form that has been generated by a loss of function…Whatever the contributing factors, a pain treatment that starts with function will rarely require you go after the body’s form.