The common symptoms of spinal stenosis are also possible indicators of many other diseases/disorders, so diagnosis is sometimes difficult. A physician will solicit information regarding recent medical history, and conduct a physical exam that checks for limits in mobility, pain, vascular problems and loss of reflexes. Other tools used for analysis may include X-ray, MRI, CAT, a myelogram (in which a liquid dye is injected in the spinal column revealing any stressed nerves), or bone scan (radioactive material identifies excessive bone formation or destruction, tumors, infections, and arthritis). Depending on the severity of pain and impediment caused by the stenosis, various methods of treatment may be prescribed. Surgery is not generally recommended immediately after diagnosis, but instead a program of postural correction, restricted activity, weight loss, physical therapy, back braces, nonsteroidal anti-inflammatory drugs, or corticosteroid injections to the outer spinal membrane may be advised. Additionally, simply leaning forward while walking or drawing the knees to the chest may alleviate pain because such actions widen the space available to the spinal cord and nerves.
For severe cases, and if simpler methods of treatment do not work, surgery may be used to relieve the pressure on the spinal cord and correct physical problems in the spine. Removing, trimming or adjusting the bones and physical structures through various methods of surgery accomplishes this end. The most common of these is decompressive laminectomy, in which the lamina (upper covering) of one or more vertebrae may be removed to create more room for the nerves. A spinal fusion may also be performed to help correct structural problems. Although surgery generally provides relief, if the nerves have already been greatly damaged, the degenerative process may continue and pain persist.
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