Dr. Naresh Pincha

What is Spinal Stenosis: The narrowing of the gaps in the spine or the backbone is called as Spinal stenosis. This leads to pressure on the nerves and the spinal cord. 5% of cases of spinal stenosis are seen in the low back of the lumbar spine. In some cases the narrowing of the spine leads to the compressing of the nerve root, which leads to pain in the leg.

Causes of spinal stenosis: It can be caused by aging, arthritis, trauma to the spine, spondylolisthesis and tumor of the spine

Symptoms of spinal stenosis: There is constant pain in the back and legs as stenosis pinches the nerve responsible for sensation and muscle power. Other symptoms are numbness and tingling in the legs, frequent falling and pain while walking.

Treatment of spinal stenosis:

-  A routine program with exercises and physical therapy are the best treatment for spinal stenosis. The exercises are not a complete cure but they are beneficial in keeping the patient active. A physical therapy can be supervised and once the period of the same is over people easily transition to the exercise program. The key for exercise is starting slowly in order to build strength.

-  Generally, the patients are counseled not to perform strenuous activities as that might worsen the symptoms of spinal stenosis. In case of lumbar stenosis, patients find it comfortable when they are flexed forward. The doctor might recommend walking while being bent over and leaning when using a walker if not walking upright; sitting in recliners is also recommended instead of straight back chairs.

-  Injections of cortisone are usually given in the epidural space. This is believed to relieve the symptoms of spinal stenosis temporarily. Though there have been studies which question the use of these injections as they lead to the risk of osteoporosis related fractures. This is still being pondered over by the doctors as a suitable treatment option as it has its own benefits and risks.

-  Medications such as the antiinflammatory medicines like ibuprofen or aspirin are helpful in controlling the symptoms of spinal stenosis. Narcotic drugs might also prove to be helpful if used with care and for a short while. This is helpful for severe pain related to the nerves. Muscle relaxants like gabapentins might also be recommended. In some case anti depressants might also be given to provide relief from pain. 

Though side effects are a concern when using these medications and the patient should let the doctor knows about their allergies.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Sciatica is probably one of those things which is vaguely familiar but a person is not fully aware of it. The sciatic nerve is one which is part of the spine and then spreads out over the legs. When this nerve gets pinched, it leads to sciatica, or pain of the sciatic nerve, which is tremendous! But, then, what exactly is a person to do in order to reduce the pain caused on account of sciatica?

The best answer for this is not medication, though it does have its uses, but rather, exercises which help the situation improve and reduce the risk of the person going mad due to the pain! One of the simplest exercises that a person can start with is known quite commonly as the knee to shoulder exercise. All that one needs to do is to lie down on the back and then, raise one knee and pull it across the body, with hands wrapped around it, so that it touches the opposite shoulder. This position of the knee touching the shoulder is to be held for about half a minute. About 3 repetitions need to be done and the same with the other side.

While it is important in the effort to relieve pain due to sciatica, it is equally important not to push oneself beyond natural limits, especially initially as this can cause injury. After all, more pain is the last thing which a person with sciatica is likely to want!

Since it is important to keep in mind the fact that consistency is one of the key secrets to reducing the sciatic pain, it is worth keeping in mind the standing hamstring stretch. What this exercise can boast of is the fact that it is one which can be done nearly anywhere. Also, it is pretty simple, too!

To do the standing hamstring stretch, one leg needs to be kept on an elevated surface which is not as high as the level of the hip. It is important to keep in mind that the leg is to be kept straight. The torso needs to then be bent towards the elevated leg. This process should be done slowly and again, maintained for about half a minute.

The sitting pose is useful to remember, as well. Sitting on the floor, one leg’s ankle should rest on the other’s knee. Like the standing hamstring stretch, the upper torso is to be bent towards the extended leg. With all these exercises, relief is not far away!

Menopause is a condition that marks the end of the menstrual cycle. It is a normal phenomenon that women experience with age. Menopause affects the bone health adversely. Bone health is directly tied to oestrogen, the hormone responsible for reproductive cycles, pain sensitivity. As a woman moves out of her fertile years there is an internal change in the reproductive system and the consequences can be seen and felt all over the body, including the bones.

The years just preceding menopause, with their hormonal fluctuations can set the stage for later health issues like bone weakening. As the oestrogen level drops, the bone density starts to decline which continues for a long period of time. The bone loss can become significant during perimenopause (the decades making up to menopause) and will speed up in the first few years of menopause.

The oestrogen level directly affects the process known as bone remodelling; the constant breakdown and the remodelling of the bone in the skeleton. With less oestrogen in the body cells called osteoclasts are able to absorb bone at a faster rate than osteoblasts (bone-building cells) are able to regenerate new bone. Thus the bone remodelling equation is no longer equal and the bone density continues to decline.

The osteoporosis risk after menopause is a serious one, yet so many women refuse to pay it much attention. Perhaps it’s because the bone damage isn’t visible, or that bone loss continues so gradually for so many years. While the bone loss cannot be completely halted, there is plenty that can be done to slow it down. Here are some ways to take care of your bone health before or after menopause.

1. Stay active: Adopting an active lifestyle after menopause helps in protecting the bones. It's recommended that adults between 19 to 64 years of age should do moderate to intense activity. This could include activities such as cycling or brisk walking. Sitting for long hours should be avoided. Weight-bearing exercises and resistance exercises are particularly important for improving bone strength and helping to prevent osteoporosis.
2. A balanced healthy diet: A healthy, balanced diet that includes calcium and vitamin D will help maintain healthy bones after the menopause. Good sources of calcium include green, leafy vegetables (but not spinach), nuts, seeds, dried fruit, tinned fish with the bones in, and dairy products like milk, yoghurt and cheese. Good food sources of vitamin D include oily fish, eggs, and fat spreads or breakfast cereals
3. Hormone replacement therapy: HRT can be an effective treatment for common menopausal symptoms like night sweats, sleep disturbance and achy joints. It works by replacing oestrogen, which naturally begins to lower post menopause. HRT can also help to maintain bone density and reduce the risk of osteoporosis.

In case you have a concern or query you can always consult an expert & get answers to your questions!