Spinal Stenosis Causes Back Pain

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DEAR DR. DONOHUE: I am 84 years old, and I have spinal stenosis, which is causing me pain. I would like to know more about it. Will you furnish more information? — T.P.

ANSWER: Spinal stenosis is a common back problem of older people. It’s said that 20 percent of those older than 60 have it. The spinal cord is an offshoot of the brain, and it travels from the brain to the lower back. It’s about the width of your little finger and is extremely delicate. That’s why nature encased it in backbones — vertebrae. Running through the backbones is a tunnel, the spinal canal that serves to protect the cord.

Spinal stenosis is a narrowing of the tunnel. It happens mostly in the neck and lower-back regions. Thickened ligaments surrounding the spinal cord or arthritic changes of the backbones impinge on the spinal cord or the nerves that spring from it.

When the process occurs in the back, pain is felt there and often in the buttocks or thighs. The pain worsens if a person stands for too long. People can ease the pain by bending forward at the waist or by sitting down. Bending opens the tunnel to give the spinal cord some breathing room. The amount of bend that works is the amount of bend a person assumes when pushing a shopping cart.

Have you tried Tylenol (acetaminophen) for pain? It’s safe when used as directed on the label. Nonsteroidal anti-inflammatory medicines such as ibuprofen (Advil) and naproxen (Aleve) also are helpful. They can cause stomach upset and stomach bleeding, so follow directions given for their use. Hot packs or cold packs might work. Try both, and see if either gets the job done.

At night, lying on your side in bed with a pillow between your knees lessens pain. A program of physical therapy might help you turn the corner. Ask your doctor for a referral. And finally, the opinion of a back surgeon will let you know if any surgical technique can bring you relief.

The booklet on back pain offers other advice for the many conditions causing back pain. Readers can obtain a copy by writing: Dr. Donohue — No. 303W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I just received my grandmother’s death certificate. It says: “Cause of death: uterine hemorrhage. Contributing cause: surgical shock.” She died in 1931 at the young age of 33. What does all this mean? — J.F.

ANSWER: Hemorrhage is massive bleeding. She bled from her uterus either during an operation or from a tumor, a twisted fibroid or an infection. Surgical shock isn’t a term used these days. Shock means that the bleeding was so great, her blood pressure dropped. Not enough blood could circulate to her organs, including her brain and heart. In those days, such a catastrophe almost always resulted in death.

I’m guessing at the meaning of surgical shock. I take it to mean that the bleeding occurred during surgery.

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