Overview
Spinal stenosis occurs when the spaces within the spine narrow and place pressure on the nerves traveling through the spine.
This condition frequently occurs in the lower back and neck. Some living with spinal stenosis will be symptomatic, while others experience pain, tingling, numbness, and muscle weakness. While spinal stenosis occurs more prevalently in those over 50, it can affect anyone. Normal degenerative changes throughout the aging process, spinal injuries, congenital spinal deformity, and genetic diseases affecting your bone or muscular development can cause spinal stenosis to develop in younger people. There is no cure for spinal stenosis, nor is there a way to prevent it. Maintaining a healthy lifestyle and giving your body enough rest can help slow the progression of spinal stenosis.
Most people living with spinal stenosis will not need surgery. If a patient exhausts all other available treatment options for this condition and does not find pain relief, medical professionals will recommend surgery. Those living with intolerable, chronic pain from spinal stenosis or whose spinal stenosis eliminated their ability to control their bowels, bladder, or sexual functions are typically surgical candidates. Seeking treatment for spinal stenosis is imperative. When left untreated, it can cause permanent numbness, weakness, balance problems, incontinence, and paralysis. These complications, however, are rare.
Treatment Options
- Medication: over-the-counter pain relievers, prescription medication such as antidepressants, anti-seizures, and opioids
- Physical therapy, gentle stretching, yoga, or functional mobility training
- Massage therapy
- Chiropractic treatment
- Corticosteroid injections
- Interspinous spacers
- Decompression procedure: This treatment option is specifically for lumbar spinal stenosis patients and those with thickened ligaments. This procedure removes a portion of the thickened ligaments in the back of the spinal column to increase the spinal canal space and remove nerve root impingement.
- Surgery: Several surgical options for spinal stenosis include a laminectomy, laminotomy, laminoplasty, minimally invasive bone or lamina surgeries, spinal fusion
Maintaining a healthy weight can help reduce pain caused by spinal stenosis, and using a cane or walker can provide stability and relieve pain when walking.
Symptoms
Symptoms of spinal stenosis vary depending on what type of spinal stenosis you have.
Cervical spinal stenosis symptoms:
- Numbness or tingling in hands, arms, feet, or legs
- Weakness in hands, arm, feet, or legs
- Difficulties walking or balancing
- Neck pain
- Decreased mobility and functionality in your hands
- Impaired ability to do daily tasks with hands, such as writing, zipping zippers, or buttoning shirts
Lumbar spinal stenosis symptoms:
- Numbness or tingling in legs or feet
- Weakness in legs or feet
- Pain in the lower back
- Back pain
- Sciatica
- Heavy feeling in legs
- Pain, cramping, or difficulty walking or standing for prolonged periods of times
Some living with lumbar spinal stenosis will experience abnormal functioning in their bowels or bladder and loss of sexual functioning.
Diagnostic Tests
Before visiting your healthcare providers, document any signs and symptoms of spinal stenosis – especially their duration, frequency, and severity. Some symptoms of spinal stenosis overlap with other medical conditions, so proper documentation of all your symptoms can help your medical professional eliminate other causes of your back pain. Before conducting a physical exam, your medical professional will ask about your medical history and familial history of spinal issues and rheumatological disorders. During the physical examination, your doctor will examine the range of motion in your spine and neck, check your spine for tenderness and any deformities. They likely will check your balance, walking, and strength in your extremities. Your healthcare provider may order diagnostic tests, such as:
- Blood tests
- CT scan or myelogram
- EEG
- MRI
- X-ray
Your doctor may refer you to a specialist for further diagnostic tests and treatment.
Types
The types of spinal stenosis are categorized by their spinal location, and you can suffer from more than one type of spinal stenosis.
The two most common types of this condition are:
- Cervical stenosis – affects your cervical spine and neck
- Lumbar stenosis – occurs in your lower back
Other types of spinal stenosis include:
- Thoracic stenosis – affects your middle pack
- Foraminal stenosis – occurs in the small openings where nerve roots exit the spinal column
- Lateral recess stenosis – occurs at the back of the spinal canal where nerve roots initially branch out
- Central canal stenosis – affects the main spinal canal that houses and protects the spinal cord
Facts
Women are more likely than men to develop spinal stenosis.
Causes
Causes of spinal stenosis include:
- Bulging or herniated disks
- Calcified spinal ligaments
- Congenital spinal stenosis – being born with a small spinal canal
- Degenerative disc disease
- Genetic disorders
- Inflammation in the back or neck
- Inflammatory spondyloarthritis
- Injury or trauma to the back or neck
- Misaligned spinal vertebrae
- Osteoarthritis
- Overgrown bones
- Paget’s Disease
- Spinal cord cysts or tumors
- Spinal injuries
- Thickened ligaments
- Tumors
