The bad thing about the assumptions is that thanks to them, many cases of people with medical conditions are observed who are only treated for a spinal problem, when it could be a medical problem in itself, or a combination of both.
For example, lumbar spinal stenosis is a condition related to the nerves and peripheral arterial disease is related to blood flow, but the two have many symptoms in common. The same is true for spinal stenosis and diabetic neuropathy, or damage to the nerves in the legs and feet. And disc problems can look a lot like inflammatory arthritis.
Find out if back pain could be due to spinal stenosis
Spinal stenosis is one of the most common causes of spinal pain not related to injury. This narrowing of the space around the spinal cord puts pressure on the nerves. If you have the following symptoms, spinal stenosis may be the cause:
• Pain in the lower back
• Leg cramps.
• A feeling of heaviness in the legs, which can cause problems walking.
• Increased pain when going downhill.
• Symptoms that get worse with physical activity.
• Feel relief to adopt the position of the "shopping cart": that is, lean forward as if you were leaning on a shopping cart.
However, "false positives" are also very common. “About 21% of asymptomatic people over the age of 60 will show signs of spinal stenosis on an MRI.
And in some cases, spinal stenosis and peripheral arterial disease coexist. This is why you need to have a physical exam and possibly other tests to get a clear diagnosis.
How to determine if your back pain could be due to more serious medical conditions
There are a few ways to differentiate between spinal stenosis and a more serious condition:
• Experiencing pain that gets worse when climbing uphill is more common with peripheral arterial disease. Which is a build-up of plaque in the blood vessels leading to the extremities.
• Patients with arterial disease are not relieved by the "shopping cart" position.
• If your symptoms get worse at night, but improve with exercise, it could be due to neuropathy.
• In young people, experiencing morning stiffness that lasts more than 30 minutes and is made worse by standing still can be a sign of inflammatory arthritis, such as ankylosing spondylitis.
• Other unexplained symptoms, such as weight loss and fatigue, can be signs of a cancerous growth; very rare, but worth looking into.
Serious problems, such as malignant neoplasms or aneurysms of the abdominal aorta, rarely present with symptoms of the spine. But in some cases they do. They are serious enough for you to consider ruling them out.
How to relieve pain if you have spinal stenosis
If you suffer from spinal stenosis, there are several treatments for back pain:
1. Try physical therapy. Stretching and strengthening can help strengthen your back, improve your balance, and relieve pressure on your nerves.
2. Ask your doctor about medications. Nonsteroidal anti-inflammatory drugs and muscle relaxants can be of great help. Some patients are also relieved by anti-seizure medications such as Neurontin, which is also used for neuropathy.
3. Consider steroid injections. Corticosteroids can reduce inflammation and irritation that cause symptoms. They are generally not a first resort because they can weaken bones and tissues over time.
4. Keep in mind that surgery may be an option. When more conservative treatments don't work, certain procedures can reduce symptoms.
What to do if you suspect another problem
In this case there is only one important piece of advice: consult a doctor, either your primary care doctor or a specialist. Each condition that mimics spinal problems comes with its own treatments, but the first step is always to have an accurate diagnosis.
For example, a nerve test such as electromyography (EMG) can help the doctor detect neuropathy, and a blood flow test such as the ankle brachial index (ABI) can distinguish between spinal stenosis and peripheral arterial disease.
It is very important to look at all of your symptoms and history and do a complete exam. This is how a doctor can differentiate between a back problem and a relevant medical condition.
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