Spinal compression occurs when pressure is placed on the spinal cord or the nerves branching from it. The spinal cord, protected by the vertebrae, transmits signals between the brain and body. Undue pressure can disrupt these signals, leading to various forms of discomfort, often including back and neck pain.
What Causes Spinal Compression
Spinal compression can arise from several underlying issues that reduce the space available for the spinal cord and nerves. Common causes include a herniated or bulging disc, where the cushions between vertebrae protrude and press against neural structures. Bone spurs, bony growths along the edges of bones, can also narrow the spinal canal and exert pressure.
Degenerative disc disease, a condition where spinal discs lose their cushioning and elasticity over time, can also contribute to compression. This degeneration often leads to a narrowing of the spinal canal, a condition known as spinal stenosis. Arthritis, particularly osteoarthritis, can cause inflammation and new bone growth that impinges on nerves. In some cases, spinal injuries, such as fractures or dislocations, can directly lead to compression by altering the structural integrity of the spine. Less frequently, growths like tumors or abscesses within or near the spinal column can also create pressure on the spinal cord or nerves.
Recognizing the Signs
The symptoms of spinal compression depend on the location and severity of the pressure on the spinal cord or nerves. Pain is a common symptom, often localized in the neck or back, but it can also radiate to other parts of the body. For instance, compression in the lower back might cause sciatica, which is pain that extends down the leg.
Numbness, tingling sensations, or muscle weakness in the arms, hands, legs, or feet are common. Severe compression can lead to loss of coordination, difficulty walking, or changes in sensation below the point of pressure. A serious but rare sign is cauda equina syndrome, involving severe leg weakness and loss of bowel or bladder control, requiring immediate medical attention.
Confirming a Diagnosis
Diagnosing spinal compression typically begins with a thorough medical history and a physical examination. During the examination, a healthcare professional assesses reflexes, muscle strength, and sensation in various parts of the body to pinpoint potential areas of nerve involvement. This initial assessment helps guide further diagnostic steps.
Imaging tests are often employed to visualize the spinal structures and identify the source of compression. X-rays can reveal changes in bone alignment or the presence of bone spurs. Magnetic Resonance Imaging (MRI) provides detailed images of soft tissues, including discs, ligaments, and the spinal cord, making it effective at showing nerve compression. Computed Tomography (CT) scans offer cross-sectional images of bone structures, which are useful in cases of bone abnormalities. Sometimes, nerve conduction studies or electromyography (EMG) might be used to evaluate nerve function and confirm nerve damage.
Pathways to Relief
Treatment for spinal compression aims to alleviate pressure on the affected nerves or spinal cord and manage symptoms. Initial approaches often involve conservative, non-surgical methods. Rest and activity modification can help reduce irritation and inflammation in the affected area.
Medications such as non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and swelling, while muscle relaxants may ease muscle spasms. Corticosteroids, delivered as oral medications or through epidural steroid injections, can provide stronger anti-inflammatory effects directly to the site of compression. Physical therapy is often recommended, incorporating exercises to strengthen supporting muscles, improve flexibility, and correct posture, which can reduce strain on the spine. If conservative treatments are insufficient or if symptoms are severe and progressive, surgical intervention may be considered to directly relieve pressure on the spinal cord or nerves.