Spinal Stenosis

Overview

Spinal stenosis is an orthopedic condition that occurs when the spaces between the spine become narrowed and put pressure on the spinal nerves.

While many people do not experience symptoms as a result of spinal stenosis, others may feel pain, tingling, numbness, or weakness in the muscles.

Spinal stenosis is also called pseudo-claudication, central spinal stenosis or foraminal spinal stenosis.

There is not a cure for spinal stenosis, but symptoms can be managed with treatment.

Spinal stenosis causes

Osteoarthritis as a result of the wear and tear on the spine due to aging is the most common cause of spinal stenosis. Spinal bones gradually wear down and form bone spurs, which can grow into the spinal cord and put pressure on the nerves.

Other conditions that cause spinal stenosis include:

• Rheumatoid arthritis. Inflammation associated with rheumatoid arthritis can increase pressure on the spinal cord leading to pain.
• Disc herniation
• Bone tumors
• Past surgery on the spine
• Narrow spinal canal
• Scoliosis
• Congenital spine disorders
• Spinal injuries from car, sporting or similar trauma

Spinal stenosis symptoms

Some patients do not experience any symptoms associated with spinal stenosis. As the nerves in the spine become more compressed, symptoms can develop or intensify.

Symptoms of spinal stenosis will vary depending upon if the pain originates from the lumbar (lower back) or cervical (neck) spine. 

Symptoms include:

• Weakness in the arms or hands (cervical) or feet or legs (lumbar)
• Pain in the neck (cervical) or the lower back (lumbar) when standing or walking
• Tingling or numbness in the arms or hands (cervical) or legs or buttocks (lumbar)
• Inability to balance
• Issues controlling bladder or bowels

Spinal stenosis complications

If left untreated, spinal stenosis may cause paralysis. Other complications include:

• Loss of feeling in your spine and extremities
• Problems balancing or walking
• Loss of bowel and bladder control

Spinal stenosis risk factors

Age is the primary risk factor associated with spinal stenosis. Most spinal stenosis patients are over 50 years old. The severity of your symptoms depends on the size of your spinal canal and the degree in which the nerves have impinged.

Spinal stenosis prevention

While spinal stenosis cannot be prevented in all cases, there are steps you can take to prevent or delay the progression of the disease, including:

• Exercising
• Improve range of motion in the spine
• Maintain good posture
• Manage your weight
• Quit smoking

Spinal stenosis diagnosis

Your doctor can diagnose spinal stenosis. During a physical exam, your doctor will observe your movements, take a full medical history, and order diagnostic testing such as:

• X-ray
• MRI scan
• CT scan
• Electromyogram
• Bone scan

Spinal stenosis treatment

Your doctor is likely to start you with exercise and over-the-counter medication as a first-line treatment for spinal stenosis.

While there is not a cure for spinal stenosis, the goal of treatment is to relieve your symptoms so you can lead a normal, active life.

If medications and conservative treatments are not effective, your doctor will develop a treatment plan customized to your case. The treatment plan will vary based on where the stenosis is location and the severity of your symptoms.

Treatments may include:

• Medications your doctor may prescribe include pain relievers, antidepressants, and anti-seizure medications.
• Physical therapy. Many patients who suffer from spinal stenosis become less active, but this may cause more pain. Physical therapy can help you build flexibility, improve muscle strength, and help balance, which can help alleviate your symptoms.
• Steroid injection. Pain and inflammation associated with spinal stenosis can be temporarily relieved with a corticosteroid injection. Your doctor will only give you an injection a few times a year to prevent bone damage.
• Nerve block. A nerve block may provide short term relief from your symptoms.
• Surgery is used as a last resort treatment for spinal stenosis. If you are in severe pain, are unable to walk, or you have lost the ability to control your bladder, you may be a candidate for surgery. Surgery will not cure your condition, but it may relieve your symptoms.

Types of surgery for spinal stenosis include:

• During a laminectomy, your doctor will remove bones, spurs, and ligaments that are putting pressure on your nerves. Laminectomies are the most common surgical treatment for spinal stenosis.
• Part of the lamina is removed to relieve pressure in the affected area.
• A laminoplasty is a surgery used for the cervical spine. During this procedure, your doctor will open the space in the spinal canal and insert metal instruments to hold the opening in place.
• Spinal fusion. A spinal fusion may be performed in addition to a laminectomy. After the laminectomy, your doctor will fuse the vertebrae to reduce movement in the spine.

When to Seek Care

Contact your doctor if you experience any of the symptoms associated with spinal stenosis. Early intervention is essential for the best outcomes.

Next Steps

Your doctor will develop a treatment plan customized for you. In many cases, patients can experience symptom relief with OTC medications and exercises.

If you need surgery, your doctor will determine which surgical procedure is most appropriate for you.

Recovery from surgery as long as three months. Follow your doctor's instructions carefully. Pushing too hard, too quickly, can negatively impact your recovery process.