Spinal Stenosis Overview
Spinal stenosis is a narrowing of the spinal canal, the cavity within the vertebral column through which the spinal cord and nerves pass. Nerves leaving the spinal cord are called nerve roots; they pass through the vertebral column via small canals. Arthritic changes that cause overgrowth of vertebral bones may compress the spinal cord or the nerve roots, impairing sensation and muscle strength in the affected portion of the body. Most common among people in their 50s and 60s, spinal stenosis affects the lumbar (lower back) portion of the spine more than the cervical (neck) region. Symptoms include pain, numbness, and weakness in the neck, arms, lower back, and legs.
What Causes Spinal Stenosis?
- Disorders that involve arthritic degeneration and abnormal overgrowth of bone tissue, such as osteoarthritis or Paget’s disease, may cause spinal stenosis.
- Age or aging of the body causes spinal stenosis.
- Spinal stenosis can be hereditary.
Symptoms of Spinal Stenosis
- Back pain that may radiate to the buttocks and legs. Pain worsens with activity.
- Numbness in the buttocks and legs
- Weakness in the legs when walking
- Back pain with loss of or changes in bowel or bladder function
- Balancing problems
- Neurogenic claudication (inflammation of the nerves emanating from the spinal cord)
- Insensitivity and losing sensation in back, neck, arms and shoulders
- Foot disorders
- Less pain when leaning forward or sitting
Spinal Stenosis Prevention
- There is no way to prevent spinal stenosis.
Diagnosis of Spinal Stenosis
- Patient history and physical examination. Reflexes in the legs are tested to assess nerve involvement.
- X-rays, sometimes with injected dyes (myelography)
- CT (computed tomography) scans or MRI (magnetic resonance imaging)
How to Treat Spinal Stenosis
- Losing weight and toning the abdominal muscles with exercise may reduce pressure on the spine. Check with your doctor before beginning any weight-loss program or new exercise regimen.
- A lumbosacral support (a corset available at some pharmacies and medical-supply stores) may discourage motion that causes pain and help ease walking and exercise. It should not be worn all day, however.
- Anti-inflammatory drugs may relieve pain.
- If pain prevents normal activities despite self-care and medication, surgery to relieve pressure on the nerves (decompression surgery) may be warranted. The surgeon opens the spinal column where narrowing has occurred and removes the constricting bone or fibrous tissue. The opening through which nerve roots pass may be widened; if an excessive amount of bone is removed, the affected vertebrae may be fused together to increase spinal stability. Physical therapy may aid rehabilitation.
- Acupuncture can help to relieve some of the pain for mild cases of spinal stenosis.
- Surgical methods such as spinal fusion and laminectomy may be recommended.
When to Call a Doctor
- Call a doctor if you have persistent pain, numbness, or weakness in the back, legs, or neck, or if back pain accompanies changes in bowel or bladder function.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media