Spinal Stenosis
Expert Spinal Stenosis Treatment in Bergen County, New Jersey.
Spinal stenosis most commonly affects two regions of the spine. Lumbar spinal stenosis develops in the lower back and is the leading cause of leg pain and cramping in older adults during walking and standing. Cervical spinal stenosis develops in the neck and can cause symptoms ranging from arm pain and numbness to serious neurological problems affecting coordination, balance, and fine motor function.
Spinal stenosis is a narrowing of the spaces within the spine that puts pressure on the nerves traveling through it. The word stenosis simply means narrowing, and in the spine, that narrowing can occur in the central spinal canal where the Spinal Cord Stimulator passes through, in the foramina where individual nerve roots exit the spine, or in both places at the same time.
It is one of the most common spine conditions in adults over 50, though it can develop at any age. It develops gradually in most people, which is why so many patients arrive at Spine Care New Jersey having lived with worsening symptoms for years before realizing that what they were experiencing had a name and, more importantly, effective treatment options.
Getting an accurate diagnosis is everything with spinal stenosis. It is a condition that is frequently confused with other causes of back and leg pain, and it is also one where the right treatment depends heavily on which part of the spine is affected, how severe the narrowing is, and how significantly it is impacting the patient’s life. At Spine Care New Jersey, Rishi N. Sheth, MD personally evaluates every patient to determine exactly what is happening and what the most appropriate response is.
SymptomsSpinal Stenosis Feels Different Depending on Where It Occurs.
The symptoms of spinal stenosis are distinctive enough that an experienced spine surgeon can often develop a strong clinical suspicion based on the patient’s history alone, before even looking at imaging. Understanding what you are experiencing, and how it fits the pattern of stenosis, is one of the first steps toward getting the right help.
Lumbar Spinal Stenosis Symptoms
The classic presentation of lumbar spinal stenosis is something called neurogenic claudication. Patients describe it as a heaviness, cramping, or aching pain in one or both legs that comes on after walking a certain distance, typically a few hundred feet to a couple of blocks. The pain often starts in the buttocks and travels down into the thighs and calves. What is characteristic about it is what makes it better: sitting down or leaning forward. Many patients report that they can walk through a grocery store comfortably by leaning on the cart, but struggle to walk unaided across the parking lot. That pattern is essentially diagnostic.
Other symptoms include lower back pain that is worse with standing and walking, numbness or tingling in the legs, weakness in one or both legs with prolonged activity, and a general sense that the legs just do not work the way they used to.
Cervical Spinal Stenosis Symptoms
Stenosis of the neck is equally important to recognize, and often more urgent in its implications. Cervical stenosis compresses the spinal cord itself, not just individual nerve roots. When the spinal cord is compressed in the neck, it can cause a condition called cervical myelopathy, which involves a cluster of symptoms including neck pain and stiffness, arm pain, numbness or tingling in the hands and fingers, loss of dexterity and grip strength, difficulty with handwriting or buttoning clothes, unsteady gait and balance problems, and in more advanced cases, weakness in the arms and legs.
Cervical myelopathy is one of the most important conditions Rishi N. Sheth, MD sees in practice, because it is progressive and irreversible if left untreated. Unlike lumbar stenosis, which tends to worsen slowly and can often be managed conservatively for extended periods, cervical myelopathy from stenosis of the neck is a condition where timely evaluation genuinely matters.
Any patient experiencing balance problems, hand clumsiness, or progressive weakness in the arms or legs should be evaluated by a spine specialist promptly.
Causes Spinal Stenosis Is Usually a Result of the Spine Aging, But That Does Not Make It Inevitable or Untreatable.
In the vast majority of cases, spinal stenosis is caused by degenerative changes that accumulate in the spine over time. These changes are a normal part of aging, but they become problematic when the cumulative effect is a spinal canal that has narrowed enough to compress neural structures.
The degenerative process typically involves several overlapping mechanisms. Bone spurs, called osteophytes, form along the edges of the vertebrae as the spine loses disc height and stability over the years. Facet joints, which connect the vertebrae to each other, can become enlarged and arthritic. The ligaments that line the back wall of the spinal canal, particularly the ligamentum flavum, can thicken and buckle inward, taking up additional space. Herniated or bulging discs add further to the compression from the front of the canal.
The end result is a spinal canal that has been progressively narrowed from multiple directions simultaneously, which is why many patients with stenosis have symptoms that develop gradually and worsen over the course of years.
Less commonly, spinal stenosis can be caused by congenital factors, meaning some people are simply born with a naturally narrower spinal canal. When degenerative changes are superimposed on a canal that was already smaller than average, symptoms often develop earlier in life and can be more severe.
TreatmentsFrom Targeted Injections to Minimally Invasive Surgery — Every Option Available in One Practice.
The right treatment for spinal stenosis depends on the severity of the narrowing, the type and intensity of symptoms, and how much the condition is affecting daily life. Rishi N. Sheth, MD takes a conservative-first approach for all appropriate patients, which means surgery is never the first recommendation unless the clinical situation makes it necessary.
Non-Surgical Treatment for Spinal Stenosis
Physical Therapy
Physical therapy designed specifically for spinal stenosis focuses on flexion-based exercises that open the spinal canal and reduce nerve pressure. Strengthening the core and the muscles around the lumbar spine reduces the mechanical load on the narrowed segments. Postural training and activity modification can help patients manage their symptoms more effectively day-to-day while other treatments take effect.
Epidural Steroid Injections
Epidural steroid injections are among the most effective non-surgical treatments for lumbar spinal stenosis causing leg pain and neurogenic claudication. Injecting anti-inflammatory medication into the epidural space directly around the compressed nerve roots can provide significant and sometimes prolonged relief, allowing patients to remain active and postpone or potentially avoid surgery.
Transforaminal Injections
Transforaminal injections target a specific nerve root with even greater precision and are particularly useful for patients with foraminal stenosis causing radicular pain in a clearly defined distribution.
Medial Branch blocks
Medial branch blocks and facet joint injections are used when facet joint degeneration is contributing to the overall narrowing and pain pattern.
For many patients with moderate lumbar spinal stenosis, a combination of these treatments, combined with activity modifications and a home exercise program, provides sufficient relief to maintain a good quality of life without surgery.
Surgical Treatment for Spinal Stenosis
Surgery for spinal stenosis is recommended when non-surgical treatments have not provided adequate relief, when symptoms are severe enough to significantly limit daily activity, or when there is evidence of progressive neurological compromise.
Spinal decompression, specifically a procedure called laminectomy or hemilaminectomy, is the most commonly performed surgery for lumbar spinal stenosis. It involves removing the portion of bone and thickened ligament that is compressing the nerve roots, creating more space within the spinal canal. Rishi N. Sheth, MD performs all decompression procedures using minimally invasive techniques, which means smaller incisions, less disruption of the surrounding muscles, reduced blood loss, and faster recovery compared to traditional open surgery.
When spinal stenosis is accompanied by instability or spondylolisthesis, a spinal fusion may be performed alongside the decompression to stabilize the spine and prevent recurrence of symptoms.
For cervical spinal stenosis causing myelopathy, surgery is typically recommended earlier than for lumbar stenosis, because spinal cord compression in the neck can cause permanent neurological damage if it progresses without intervention. The specific surgical approach depends on the location and extent of the stenosis, and Rishi N. Sheth, MD will discuss all options in detail during your consultation.
All surgical procedures at Spine Care New Jersey are performed using minimally invasive techniques, with Mazor robotic assistance when appropriate, to reduce operative risk and accelerate recovery.
The Spinal Stenosis Specialist Bergen County Patients Trust.
Spinal stenosis is a condition where experience and precision matter enormously. The anatomy of a narrowed spinal canal leaves less margin for error during decompression surgery, and the decision about when surgery is actually needed, as opposed to when conservative care can still do the job, requires the kind of clinical judgment that only comes from years of focused spine practice.
Rishi N. Sheth, MD has treated spinal stenosis at both ends of the severity spectrum. Patients with mild to moderate lumbar stenosis who simply need the right injection and the right physical therapy program to reclaim their ability to walk without pain. And patients with severe cervical myelopathy from stenosis of the neck, where delaying surgical intervention any further would mean risking permanent neurological injury.
What patients consistently report about their experience at Spine Care New Jersey is that they finally feel like someone took the time to actually understand their situation. Not a rushed appointment with a physician assistant. Not a recommendation that felt pre-decided before the examination even started. A real, thorough evaluation with a surgeon who explains what is happening in terms that make sense, and then gives an honest recommendation based on what that specific patient actually needs.
For patients requiring surgery, Rishi N. Sheth, MD’s Mazor robotic surgery certification and minimally invasive surgical training mean that even complex decompression procedures are performed with the greatest possible precision and the lowest possible risk. That level of surgical technology and training is not standard in most private practice spine settings in northern New Jersey.
Common Questions About Spinal Stenosis at Spine Care New Jersey.
Spinal stenosis is a condition where the spinal canal becomes narrowed, placing pressure on the spinal cord and nerves. This can interfere with nerve signals, leading to pain, weakness, and reduced mobility, especially in the lower back or neck.
Early spinal stenosis symptoms may include mild back or neck discomfort, stiffness, and occasional tingling in the arms or legs. These symptoms often worsen gradually, especially with prolonged standing or walking.
The progression of spinal stenosis is often described in four stages:
- Early degeneration with minimal symptoms
- Disc dehydration and increased discomfort
- Noticeable spinal narrowing with nerve compression
- Advanced stenosis with chronic pain and limited mobility
Unlike general spine conditions, spinal stenosis specifically involves narrowing of the spinal canal. It often develops as a result of age-related changes, but its defining feature is nerve compression caused by reduced space in the spine.
Spondylosis refers to general wear and tear of the spine, while spinal stenosis is a specific condition where narrowing compresses nerves. Neither is inherently “more serious,” but stenosis tends to cause more noticeable symptoms due to nerve involvement.
Activities that involve prolonged standing, walking downhill, or extending the spine can worsen spinal stenosis symptoms. Many people find relief when sitting or bending slightly forward.
Spinal stenosis most commonly affects adults over the age of 50 due to natural spinal degeneration. However, younger individuals may develop it due to injury, genetics, or congenital spinal conditions.
Yes, spinal stenosis symptoms can fluctuate. Some people experience periods of mild discomfort followed by flare-ups, especially after physical activity or long periods of standing or walking.