Spinal stenosis is a narrowing of the spaces within the spine. Though it can occur anywhere in the spine, it is most likely to occur in the lumbar spine (the lower back) and the cervical spine (the neck). The type of spinal stenosis is classified according to the location. For example, if the stenosis is occurring in the lumbar region, it will be called “lumbar stenosis.”
Symptoms of spinal stenosis worsen over time. Typically, symptoms are not present initially, but then pain, muscle weakness, tingling, and numbness will occur. Other symptoms may be present based on the location of the stenosis.
Stenosis will be present on an MRI or CT scan, even when symptoms are not present, making it easy to diagnose.
There are various causes of spinal stenosis. Some people are born with a small spinal canal, but most people experience stenosis when something happens to the canal, such as bone spurs or an overgrowth of bone (such as Paget’s disease), herniated discs, tumors (a rare cause), and spinal injuries.
Fibromyalgia affects women more than men, and it affects 2-4% of our population. It is also difficult to diagnose – there is no one single test that is used. Healthcare providers diagnose fibromyalgia based on subjective and objective symptoms, though they may use various diagnostic tests to rule out other conditions. There is also no cure – medications and self-care are used to reduce symptoms.
If it seems like you’ve been hearing about more people with fibromyalgia, you’re probably right – providers are getting better at diagnosing it, though it can still take a while. It is a fairly common neurologic condition that causes widespread pain, tenderness, and fatigue.
The most common symptoms of fibromyalgia include:
- Tenderness to touch affecting the muscles, joints, and even the skin
- Severe fatigue
- Sleep problems – for example, feeling unrefreshed even after sleeping 8 hours
- Problems with memory
No one knows what causes fibromyalgia. Researchers do know that it is not an autoimmune disorder but believe that it involves the central nervous system – the brain and spinal cord. For some people, there seems to be a familial tendency, though genetics is not a guarantee.
According to the American College of Rheumatology, “Fibromyalgia has been described as Central Pain Amplification disorder, meaning the volume of pain sensation in the brain is turned up too high.”
Fibromyalgia is also considered medically benign. This does not mean that it doesn’t cause significant issues to those that suffer from it, but it does not seem to cause other comorbidities, such as heart attack, stroke, or cancer.
Those with fibromyalgia may indeed have significant back pain, as well as significant pain in general. This pain can be consistent, or it can vacillate to other locations.
Rare Causes of Back Pain
Although the causes of back pain listed above should be taken seriously and can cause significant pain, they are typically not life-threatening. The below causes of back pain can be life-threatening if left untreated. Please note that while they may cause back pain, they will also likely cause a host of other accompanying symptoms as well.
Cauda Equina Syndrome
When a disc ruptures, back pain is typical. However, cauda equina syndrome is a rare complication of a ruptured disc. The material from the disc is pushed back into the spinal canal; this causes compression on the lumbar and sacral nerve roots. This compression causes a loss of bladder and bowel function, which is permanent if left untreated.
Abdominal Aortic Aneurysm
The aorta is the large blood vessel that supplies blood to the abdomen, pelvis, and legs. When this vessel becomes abnormally large, an aneurysm is said to have occurred, and it is termed abdominal aortic aneurysm (AAA). Back pain is typical with an AAA, especially if the AAA is growing larger. Many AAAs are asymptomatic, but there can be various other symptoms.
Treatment of Back Pain
Treatment of back pain is dependent on the cause of the back pain, as well as the location of the back pain. For example, treatment for back pain related to a AAA is vastly different from treatment for back pain related to fibromyalgia!
In general, you should seek expert opinion for the treatment of your back pain. Your healthcare provider may recommend that you start physical therapy, perform exercises at home, take certain medications, or even have certain procedures to treat the pain.
Most people, unless there is a contraindication, can tolerate a light walking and stretching routine.
The Bottom Line…
There are many causes of back pain, and we’ve outlined some of the more common causes in the article above. This article is in no way exhaustive, so you can use the information as a starting point as a discussion with your healthcare provider.