[RC] Cervical Stenosis and Riding - Bruce Weary DC
Hi Mary--
You ask some very good questions about spinal stenosis and it's
complications. First off, the term "stenosis" means "narrowing." In
this case, it refers to narrowing of either the spinal canal (where the
spinal cord lives) and/or the "side tunnels" where the nerves come out
of the spine. This is a result of overgrowth of bone, cartilage, disc
and connective tissue into these spaces as a result of injury, wear and
tear, and sometimes genetics. The condition itself isn't painful, until
it begins to encroach on pain sensitive tissues nearby. It's not
reversible, and sometimes surgery is necesssary to open up some of
these crowded areas to relieve pain and to release nerve or spinal cord
pressure. There may be some general loss of range of motion, but most
folks with stenosis don't know they have it unless it is discovered on
an xray or MRI, or if they have symptoms. A spine can endure a lot of
this "overgrowth" before symptoms ever show up. In other words, I would
agree with your neurosurgeon that you don't need surgery, and I would
follow up with a good chiro. Many symptoms that sometimes are
attributed to stenosis are, instead, mechanical, and not related to the
stenosis that may be present. In fact, gentle, intelligent manipulation
may be your best ally in staying mobile and pain free. When the
symptoms progress and are unrelenting, call the neurosurgeon. A CT and
an MRI will be very useful in assessing the extent of the stenosis, and
should correlate with your symptoms. In other words, if you
have stenosis on the left side of your neck, but numbness in the right
arm, the doctor needs to do some more searching for the right answers.
As far as the danger of paralysis or whiplash, it's not clear who would
sustain more damage from a fall or whiplash--those with or without
stenosis. It depends on how the injury occurs and other factors.
Unless you have instability or some other factor like osteoporosis that
make you vulnerable, you can probably ride as safely as most people. In
my experience, when people with moderate stenosis injure themselves,
they often sustain damage to the regions of the spine that are more
mobile, as the stenotic regions are usually stiffer and less mobile,
and more stabilized. In fact, in cases of severe stenosis, the symptoms
usually preclude activities like riding, and sometimes surgical fusion
is done to alleviate symptoms.
I charge $400 per hour and it took me 15 minutes to type this. That
will be $100, please. We take Visa and Mastercard. Good luck,
Dr Q
