Beating spinal stenosis struggles

back pain

He calls himself “semi-retired,” but Avon Morgan is still looking forward to brighter days ahead.

The 72-year-old from Champaign, Illinois, is living with spinal stenosis. The bad news: the ailment often does not come with symptoms at first, and there’s no sure-fire way to prevent it. The good news: there are a range of treatments that can give people their life back.

“Picking up my grandkids. Those are the things I look forward to,” Morgan points to as an example.

“They call me Pops,” he adds with a smile. “They want Pops to pick them up. It’s been hard to do.”

What is spinal stenosis?

Zeeshan Ahmad, MD, is a spine physiatrist in pain management at OSF HealthCare who treated Morgan. He says spinal stenosis is a narrowing of the spinal canal and the side canals where nerves come out of the spine. There are several causes, all occurring over a period of time rather than suddenly.

• The discs in our spine weaken and become soft, and the bones move closer to each other. This narrows the side canals.
   
• Joints in the lower back weaken and cause bone spurs.
   
• A ligament that lines the spine thickens.

Dr. Ahmad says many people in their 40s, 50s and 60s are experiencing these internal changes but have no pain right away.

“If the stenosis becomes so bad that the nerves start to feel pressure, that’s when symptoms occur,” Dr. Ahmad explains.

Symptoms include back and leg pain. People often complain of pain after standing or walking for as little as 10 minutes, Dr. Ahmad says.

Diagnosis, treatment and prevention

Dr. Ahmad says a provider could perform a physical examination and imaging (an X-ray and/or magnetic resonance imaging, an MRI) on a person to land on a spinal stenosis diagnosis. Conservative treatment might include anti-inflammatory medication and/or physical therapy. Dr. Ahmad also says people have reported that sitting or bending over forward helps. Think of hunching over a cart at the grocery store. More advanced treatment could include an injection of lidocaine and/or a steroid. This reduces inflammation and pressure on the nerves. In severe cases, a doctor will consider surgery. There are several types:

• A doctor could drill holes in the back bones called lamina. It decompresses the area and creates more space.
   
• In a less invasive type of procedure, Dr. Ahmad says a doctor can send a probe into the body and “clean up” pieces of bone. This also leads to decompression.
   
• Fusion surgery involves inserting rods and screws into the spine to support the bones.

“Doctors feel that the bones are already unstable, and if they do some cutting it will become more unstable. They also see slippage of the bones,” Dr. Ahmad says, describing the need for fusion surgery.

While there’s no way to prevent spinal stenosis, healthy habits can help. Control your weight, eat healthy and practice good posture.

“If our muscles and posture are compensating for all the weaknesses that we are developing because of degeneration, the spine is held better. It maintains its space for the nerves,” Dr. Ahmad says.

Morgan’s story

Morgan says he started seeing doctors for lower back pain in 2010. He heard about arthritis and bulging discs before landing on the diagnosis of spinal stenosis.

“Once I figured out that it seemed like this was going to be a long-term situation, it really affected me,” Morgan says. “At times, I couldn’t lift things. I couldn’t lift my grandkids.”

Dr. Ahmad was able to review Morgan’s health history and determined an injection of lidocaine and a steroid was the best option. That happened in January of 2024.

“The lidocaine was what stopped the pain for the first four days. It gave the other medication time to work,” Morgan recalls Dr. Ahmad explaining to him.

And Morgan has reported minimal pain since. Like other people who receive injections for back issues, he may get another jab in a few months if his care team calls for it.

“When you have a diagnosis like stenosis, it’s something that’s not just going to go away quickly. You have to figure out how to manage the issue,” Morgan advises. “Talk with a professional. Hopefully they will be able to guide you.”