I see patients almost every day for the management of spinal stenosis. It is a common degenerative disease that can cause quite a bit of discomfort, interfere with activities of daily living, and in some cases result in significant disability.
What is Spinal Stenosis
First a quick anatomy lesson: The spinal cord travels down your spine in a canal surrounded by 24 bones (vertebra). As the spinal cord descends down your back, pairs of nerves exit through small holes (foramen) between the vertebra. These spinal nerves go to your muscles, organs, etc.
In spinal stenosis a combination of degenerative arthritis, disc bulge/herniation, spinal joint degeneration, and ligament thickening leads to encroachment (stenosis) into either, or both, the spinal canal and the spinal nerve foramen.
Symptoms
The symptoms of lumbar stenosis are chronic low back pain, unilateral or bilateral buttock/leg pain, leg weakness, and numbness in the legs and feet.
One of the hallmarks of stenosis is something called “neurogenic claudication,” in which the person develops low back and/or leg pain after a period of walking that progressively worsens as you continue to walk.
Symptoms frequently subside when the person stops walking and bends forward. Flexing forward opens the spinal canal and relieves pressure on the nerves and spinal cord. This explains why these patients sometimes walk around stooped forward. Walking with a flexed posture helps to relieve their symptoms. Similarly bending backwards can aggravate symptoms, which is why walking uphill (where you tend to lean back) can sometimes make these patients worse.
Diagnostic Imaging
Although you can infer that someone has stenosis from their symptoms, exam findings, and X-ray, the definitive test is an MRI. The report may descvribe degeneration of the disc and spinal joints, disc bulging, ligament thickening, and narrowing of the spinal canal and/or neural foramen.
Treatment
Spinal stenosis can be progressive, and while it is the most common reason for spinal surgery in older adults in the U.S., it can usually be managed using conservative care.
In my office I treat lumbar and cervical spinal stenosis with a combination of traditional or non-force manipulation, flexion/distraction, neuro-mobilization, massage, myofascial release, and individualized rehabilitative exercises.
Occasionally, in patients who have more severe symptoms, I may refer to a pain management practitioner for a spinal injection to get a patient over a hump so they can continue with conservative care.
Do you have any questions about spinal stenosis? If so, please let me know.
Our Team
Dr. Charno is amazing. I feel like I should wait to review until I have had more than one appointment, but as someone who has had almost 40 years of chiropractic care, I know when I have found someone great. Dr. Charno is not only knowledgeable, experienced and talented, but has a powerful healing demeanor. I have seen countless doctors for my MS, but after one session I feel better than I have in years.
Nora P
A talented healer, and a great listener. I've known Dr. Charno for decades, and am thrilled that he has relocated his practice to the Mid-Hudson Valley. He treated me yesterday using Graston technique, and it really helped sooth and release a nagging muscle injury. His practice is part of the lovely Izlind Wellness Center in Rhinebeck.
Will H
Dr. Charno is hands down the best chiropractor I’ve been to. He genuinely cares about his patients and takes extra time to ask questions, understand pain, and develop action plans to relieve symptoms. He’s open minded and looks at issues from all angles, performing informed adjustments and following up with workouts and stretches to reinforce them. He is personable, caring, and an all-around wonderful doctor. I would recommend him to anyone!
Tessa Z
Dr. Charno has literally gotten me through months of quarantine. His online strength training classes have me stronger and healthier than I was six months ago. When it became possible, I began seeing him in his office and found a comprehensive and holistic approach to chiropractic. His treatment is state of the art and includes specific exercises to reinforce the adjustment. He always follows up with online exercise reminder videos. Bottom line is that Dr. Charno is a caring, effective, healer.
Amy H
I have stated to Dr. Charno that prehab for joint replacement should indicate strength training just as rehab requires physical therapy. Dr. Charno has the expertise of Chiropractic and sports injuries. I am looking forward to becoming a Dr. Charno Chiropractor patient!
Jane B
I have MS, scoliosis, and a lot of wear and tear from being a gymnastics coach for many years. Needless to say, I have a lot of issues. Dr. Charno has not only met my challenges with ease, but has changed my life. Because of him I am no longer in constant pain. I even stopped having to use a cane since seeing him regularly. If I ever have to move, I hope it is commutable to Rhinebeck so that I can forever see Dr. Russell Charno for chiropractic care.
Nora P
I suffered years of degenerating function. One visit to Russell Charno, DC, restored at least 70% of my mobility. Unlike other chiropractic offices, this doc only sees one patient at a time. My appointments are always intensive, more than an hour and 100% hands-on. I have experienced ongoing improvement. I now take CrossFit classes because I have my mobility back.
Maria C