Stenosis is from degenerative changes in the intervertebral discs and joints of the spine. Stenosis may be from any significant narrowing into the canal space or from a combination of changes that all lead to stenosis. The perimeter of the spinal canal is made up of a combination of structures including the intervertebral disc, the foramen, facet joints, and ligamentum flavum.
Patients with spinal stenosis become symptomatic when pain, motor weakness, paresthesia, or another neurologic compromise causes distress. Spinal stenosis of the thoracic spine is more likely to directly affect the spinal cord because of the relatively narrow thoracic spinal canal.
Some people with thoracic spinal stenosis find sitting or straightening the upper back helps alleviate their symptoms. Deep tendon reflexes — which are tested by striking the knee and other regions of the body with a reflex hammer — may also be heightened or diminished. Imaging studies, such as an MRI, can help identify the cause and severity of spinal stenosis. If you are concerned you may be experiencing symptoms of thoracic spinal stenosis, make an appointment with your doctor to determine the cause and appropriate treatment for your symptoms.
For mild spinal stenosis, physical therapy is often used in conjunction with medications to stabilize and improve symptoms. A therapy program assists in calming pain and inflammation and improving mobility and strength. Traction therapy can gently stretch the joints and muscles in spine to provide symptom relief. Chiropractic manipulation should never be performed with spinal stenosis. When medications and therapy fail to improve symptoms, steroid injections can reduce inflammation surrounding the nerves to ease pain and protect the spinal cord. Spinal stenosis may progress to become worse. Surgery is warranted in cases of cervical myelopathy or intractable lumbar spinal stenosis. Multiple surgical procedures exist to treat stenosis and depend on your specific pathology. All surgery shares the goal of relieving pressure on the spinal cord.