Your spine is made up of 33 vertebrae precisely stacked on top of each other, each separated by a cushioning intervertebral disc and held together by ligaments and muscles. These hold the spine like a giant coiled spring to support your body, while keeping your back flexible and incredibly strong.
As you get older, your spine can become weakened by problems such as arthritis or from the trauma of a fall. This can lead to changes in the vertebrae and the surrounding tissues, including the discs. Not only does this cause pain or stiffness of the spine, but it can alter the shape of the spinal canal – the hole in the middle of your spine where your delicate spinal cord runs.
Your spinal cord is a large nerve and the narrowing of your spine canal can cause it to become compressed or damaged.
This narrowing is known as spinal stenosis and two parts of the spine are particularly vulnerable – the cervical spine in your neck, and the lumbar spine in the lower back. Most people over the age of 50 have some degeneration of their spine and up to six per cent will develop stenosis.
Cervical stenosis affects your neck and can cause pain in your neck and shoulders, your arms may feel weak and you may find it harder to get around and struggle with activities such as writing or doing up buttons. You may also be more prone to falls.
Lumbar stenosis causes weakness, tingling and numbness in your lower back, buttocks and legs and you may find it hard to walk very far. You may find the pain eases if you bend forward because this opens up your spinal canal and relieves pressure on your nerves.
Your GP will refer you to the hospital, where you’ll usually have an MRI scan to check your spine. Most people with spinal stenosis eventually need treatment. Steroid injections can temporarily relieve the pain, but often surgery is recommended to open up your spine and decompress the nerves. This is a major operation, but can bring great improvements.
Staying as mobile as possible is important, because this not only keeps the muscles and ligaments strong and flexible, maintaining mobility and balance, but also brings nutrients to your spine. But some movements can aggravate the symptoms and you may find that using an exercise bike is more comfortable than walking. A physiotherapist can assess and advise you. Losing excess weight can also help.
Q. My wife has had a persistent cough for about three months – she doesn’t smoke. What could it be?
Dr Trisha says: This isn’t unusual and top of the list is persistent inflammation following a respiratory infection. This can happen to anyone, but if your wife has a history of allergies or asthma it might take her longer to recover.
Chronic inflammation after a cold or sinusitis can also lead to postnasal drip – mucus that trickles down from the back of the nose into your airways, generating a persistent cough.
A cough may be a sign of trouble in other systems, too. When a person has a hiatus hernia, reflux of acid back up from the stomach can irritate your throat and respiratory system. Talk to your doctor, who may decide that a chest x-ray is necessary to check for possible causes.
- Dr Trisha writes a column every fortnight in Yours magazine. Ask Dr Trisha about your health problems by emailing firstname.lastname@example.org.