What is a Pinched Nerve? Part 2

Spinal Stenosis and the Pinched Nerve

Spinal stenosis can be another reason for having a pinched nerve with resulting radiating pain, and possibly numbness and weakness, in the arm or leg. It’s important to understand how spinal stenosis relates to a pinched nerve.

As we age, our spine undergoes normal wear and tear changes called degeneration. This degeneration is also influenced by our genetic make-up, inherited spinal conditions, the kind of work we’ve done in our life, and how well we have taken care of ourselves, for instance, if we have abused alcohol or been a smoker.

Even if we have been angelic in our habits for a lifetime, the strain from standing upright and all the tasks we ask of the body causes wear and tear to our spinal joints. This degenerative process includes thinning of our discs and disturbances to our joint mechanics. One way the body responds to this degeneration is to lay down more bone, probably in an attempt to stabilize the degenerating joint. Thus a degenerated spinal joint is characterized by small outgrowths of bone, called bone spurs.

Another important characteristic of the bone production occurring with degeneration is a narrowing of the canal which houses our spinal cord and the canals through which our spinal nerves exit. Such a narrowing is referred to as stenosis.

Many of us live with various degrees of stenosis and never have any problems or symptoms associated with this condition; however, if we have inflammation of the root of a nerve in a canal that is already a tight space, we can have a pinched nerve.

What causes a pinched nerve root with inflammation in an older person with stenosis? Usually symptomatic spinal stenosis is not caused by a bulging or herniated disc because in our later years our discs become more fibrous and have less chance of herniating.

Painful stenosis is most often associated with mechanical strain, a build-up of stresses to the low back or neck, or some injury causing a strain or stretching of the nerve with resultant swelling and inflammation.

Once this inflammation occurs in a canal that is narrowed, there can be resulting radiating or radicular pain extending into the arm accompanying neck stenosis, and into the leg when there is low back stenosis. Tingling and episodes of loss of sensation can also accompany stenosis from compression of the nerve root and injury to the nerve roots sensory fibers.

In Part 3 of our discussion of pinched nerves, we’ll see how spinal joint restrictions or fixations can cause a painful pinching sensation that feels like a pinched nerve.

(Dr. Arn Strasser is a chiropractor who practices in Portland, Oregon. For more information and appointment questions, please call 503.287.2800.)

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