Spinal Stenosis

Overview

Spinal stenosis occurs when the spaces within the spine narrow, putting pressure on the spinal cord or spinal nerves. The narrowing can occur in the central spinal canal or in the openings where nerves exit the spine (foramina).

This pressure on the nerves can lead to pain, numbness, or weakness. Spinal stenosis most commonly affects the lower back (lumbar spine) but can also occur in the neck.

The condition often develops gradually and may worsen over time.

Urban Spine and Joint

Symptoms

Symptoms depend on which nerves are affected but may include:

  1. Lower back or neck pain
  2. Numbness or tingling in the arms, legs, or buttocks
  3. Weakness in the arms or legs
  4. Pain or cramping in the legs when standing or walking
  5. Balance problems or difficulty walking

Symptoms often improve when sitting, bending forward, or resting.

Causes

Spinal stenosis is usually caused by age-related changes in the spine.

Common causes include:

  1. Degenerative spine changes associated with aging
  2. Herniated discs
  3. Osteoarthritis or rheumatoid arthritis
  4. Thickened ligaments within the spine
  5. Bone spurs that narrow the spinal canal
  6. Spinal injuries
  7. Tumors affecting the spine

Less common causes include congenital spine abnormalities, scoliosis, Paget’s disease, and achondroplasia.

Diagnosis

Diagnosis begins with a medical history and physical examination. A doctor will evaluate symptoms, spinal movement, reflexes, strength, and balance.

Imaging and diagnostic tests may include:

  1. X-rays to evaluate spinal alignment, arthritis, and bone spurs
  2. MRI scans to detect nerve compression and soft tissue changes
  3. CT scans to provide detailed images of the spine
  4. Electromyography (EMG) and nerve conduction studies to evaluate nerve function
  5. Myelograms to identify pressure on the spinal cord or nerve roots

These tests help determine the location and severity of spinal narrowing.

Treatment Options

Treatment usually begins with non-surgical care.

Common treatment options include:

  1. Pain medications or anti-inflammatory drugs
  2. Physical therapy to improve mobility and strengthen supporting muscles
  3. Activity modification

Surgical Treatment

If symptoms continue, steroid injections may be used to reduce inflammation around compressed nerves.

Surgery may be recommended when symptoms are severe, progressive, or when nerve compression leads to significant weakness, loss of bowel or bladder control, or other serious complications.

When to Seek Evaluation

Persistent lower back pain, neck pain, or radiating nerve pain should not be ignored. Early evaluation allows for proper diagnosis and targeted treatment, helping prevent progression and long-term complications.