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Spinal Stenosis

 

What is spinal stenosis?

Spinal stenosis is the narrowing of the bones, joints and canal that makes up your spine. A tightened space can cause your spinal cord or nerves to become irritated, compressed or pinched. This can lead to back pain and other nerve issues, like sciatica.

Spinal stenosis can affect anyone, but it is especially common in people over the age of 50. Stenosis can occur along any area of the spine (cervical, thoracic, lumbar), but is most common in the lumbar area. Nearly every adult’s spinal canal narrows with age; however, for most people this does not cause symptoms. Narrowing of the nerve root canal (lateral stenosis) presses on the spinal nerves, causing inflammation and pain. Narrowing of the spinal canal (central stenosis) presses on the spinal cord causing inflammation and weakness.

What causes spinal stenosis?

Spinal stenosis has several possible causes. Many different changes can cause a narrowing of your spinal canal, either developing after birth (acquired) or from birth (congenital). 

Acquired spinal stenosis simply means you develop it later in life – most commonly after the age of 50. Causes of acquired spinal stenosis can include:

  • Bone overgrowth – as the cartilage in your joints wears away, also known as osteoarthritis, your bones begin to rub against each other. Your body responds by growing new bone, sometimes extending onto your spinal canal, narrowing the space and pinching the nerves in your spine.
  • Bulging or herniated disks – as you age, the discs between your vertebrae dry out and flatten, causing the gel-like center to break through due to cracking. The bulging disk then presses on the nerves near the disk.
  • Thickened ligaments – arthritis can cause ligaments to thicken over time and bulge into your spinal canal.
  • Spinal fractures – broken or dislocated bones near your spine can narrow your canal space.
  • Spinal cysts or tumors – growths within your spinal cord or between vertebrae can narrow your spinal cord.

Congenital spinal stenosis affects babies and children as they are caused from birth. This can happen due to:

  • Issues with spinal formation during development
  • Genetic conditions

What are the symptoms of spinal stenosis?

Since there are multiple kinds of spinal stenosis, symptoms will vary depending on the location. Some people describe their pain as a dull ache, others as an electric or burning sensation. Depending on where and how severe it is, you may feel the following in your neck, back, arms, hands or feet:

  • Pain
  • Numbness
  • Tingling
  • Weakness

Symptoms of lumbar spinal stenosis can include:

  • Pain in the low back
  • Pain that begins in the buttocks and extends down your leg.
  • “Heavy” feeling in your legs, leading to cramping.
  • Numbness or tingling in your buttocks, leg or foot.
  • Pain that worsens with long periods of standing or walking.
  • Pain that lessens when you lean forward, walk uphill or sit.

Symptoms of cervical spinal stenosis can include:

  • Neck pain
  • Numbness or tingling in arm, hand, leg or foot.
  • Weakness or clumsiness in your arm, hand, leg or foot.
  • Balance problems.
  • Decreased function in your hands.

How is spinal stenosis diagnosed?

Your healthcare provider will review your medical history, perform a physical exam, and inquire about your symptoms. They may feel your spine to determine the spot of the pain. You will also have imaging tests to determine the exact location, type and extent of the problem, including:

  • Spine X-ray – to show changes in bone structure.
  • MRI – provide detailed images of the nerves, disks and spinal cord.
  • CT scan – to show clear images of your spinal cord and nerves.

What are treatment options for spinal stenosis?

Even if you are healthy and active, it is important to seek treatment as soon as you experience back pain or other symptoms. Spine pain does not always mean spinal surgery. Your spine is a delicate and complex area. Because of this, your provider will likely start with conservative treatments, such as:

  • Applying heat or cold
  • Exercising
  • Medication
  • Physical therapy
  • Steroid injection

If noninvasive treatments don’t work, your provider may recommend surgery to improve the pain. The type of surgery you will need will depend on the cause, location, and severity of your symptoms. Surgical options may include: 

If you notice new back pain or other symptoms, like tingling or weakness in your extremities, contact your healthcare provider right away.