Backache intervertebral disc or spinal canal?

Strong leg pain speak for spinal canal stenosis

01/22/2015

Back pain has long been one of the so-called „common diseases“, under which about every eighth suffers across all walks of life. Causes include lack of exercise, sitting for hours and unilateral load. In 80 percent of those affected complaints disappear after one or two weeks at the latest. On the other hand, if they last longer than six months, experts talk about chronic ailments. Problems on the intervertebral discs, as well as narrowing in the spinal canal, so-called spinal canal stenoses, are among the most common causes of chronic back pain. The type of symptoms indicates which disease sufferers suffer.

„The vertebral canal stenosis is a narrowing of the spinal canal“, explains Dr. Thomas Bierstedt, spine surgeon and specialist in neurosurgery from the Orthopedic-Neurosurgical Center in Datteln and Recklinghausen. „These constrictions arise among other things by protrusions of the intervertebral discs, widened vertebral joints or thickened ligaments.“ In herniated disc, the fibrous ring of the intervertebral disc ruptures and the gelatinous contents thereof bulge into the spinal canal. In particularly large herniated discs, it can also lead to a compression of the spinal cord and thus to Spinalkanalstenose. However, they are very rare. If the disc herniation occurs in the area of ​​the lumbar spine and presses on nerves, violent back pain sets in. Most of the time, they occur suddenly and exercise aggravates the pain. In vertebral canal stenosis, on the other hand, there are primarily severe leg pain in addition to back pain. „Often patients also complain of neurological deficits such as sensory disturbances and motor failures according to the affected segment“, explains Dr. Bierstedt. „The clearest difference in the symptoms, however, is that people with vertebral canal stenosis complain, even on short stretches, of extreme pain in the legs with temporary deficits such as numbness and weakness of the legs. This improves when they stop and bend over in front.“ With such a trunk prone the spinal canal expands and the permanent pressure on nerves and vessels decreases. That's another reason patients often have almost no complaints when cycling.

The good news for people with chronic pain: Whether a herniated disc or spinal stenosis - usually the symptoms can be treated by conservative treatments using targeted exercise therapies, heat treatments, electrotherapy and other physical applications as well as acupuncture and neurostimulation. Only in the case of severe herniated discs or severe narrowing in the spinal canal must surgery be performed. „In a spinal stenosis, we surgically remove narrowing in the spinal canal and stabilize the spine with a dynamic TOPS implant“, clarifies Bierstedt. „This flexible spine stabilization ensures that the patient remains mobile and permanently painless in all directions after surgery.“ There are also modern procedures for intervertebral disk surgery. (Pm)