This condition narrows the amount of space within the spine. This can squeeze the nerves that travel through the spine. Surgery is sometimes needed.
Spinal stenosis happens when the space inside the backbone is too small. This can put pressure on the spinal cord and nerves that travel through the spine. Spinal stenosis occurs most often in the lower back and the neck.
Some people with spinal stenosis have no symptoms. Others may experience pain, tingling, numbness and muscle weakness. Symptoms can get worse over time.
The most common cause of spinal stenosis is wear-and-tear changes in the spine related to arthritis. People who have severe cases of spinal stenosis may need surgery.
Surgery can create more space inside the spine. This can ease the symptoms caused by pressure on the spinal cord or nerves. But surgery can't cure arthritis, so arthritis pain in the spine may continue.
Spinal stenosis often causes no symptoms. When symptoms do occur, they start slowly and get worse over time. Symptoms depend on which part of the spine is affected.
Spinal stenosis in the lower back can cause pain or cramping in one or both legs. This happens when you stand for a long time or when you walk. Symptoms get better when you bend forward or sit. Some people also have back pain.
Spinal stenosis in the neck can cause:
Spinal bones are stacked in a column from the skull to the tailbone. They protect the spinal cord, which runs through an opening called the spinal canal.
Some people are born with a small spinal canal. But most spinal stenosis occurs when something happens to reduce the amount of open space within the spine. Causes of spinal stenosis include:
As your spine ages, you're more likely to have bone spurs or herniated disks. These problems can shrink the amount of space available for your spinal cord and the nerves that branch off it.
Most people with spinal stenosis are over age 50. Younger people may be at higher risk of spinal stenosis if they have scoliosis or other spinal problems.
Your health care provider may ask about your symptoms and medical history. You may have a physical exam. You also may need an imaging test to help find the problem.
These tests may include:
Treatment for spinal stenosis depends on how severe your symptoms are.
Your health care provider might prescribe:
A physical therapist can teach you exercises that may help:
Your nerve roots may become irritated and swollen at the spots where they are being pinched. Injecting a steroid medication into the space around the pinched nerve may help reduce the inflammation and relieve some of the pain.
However, steroid shots may not be the best choice for spinal stenosis. Some studies have shown that combined injections of steroids and a numbing medicine relieve back pain no better than shots of numbing medicine alone.
This is important because steroids can cause serious side effects. Repeated steroid injections can weaken nearby bones, tendons and ligaments. That's why a person often must wait many months before getting another steroid injection.
Sometimes, the ligament at the back of the lumbar spine gets too thick. Needle-like tools inserted through the skin can remove some of the ligament. This can create more space in the spinal canal to reduce pressure on nerve roots. You may be given medicine to help you feel calm during the procedure. Many people can go home the same day.
Surgeries to create more space within the spinal canal may include:
In most cases, these operations help reduce spinal stenosis symptoms. But some people's symptoms stay the same or get worse after surgery. Surgical risks include:
A lumbar laminectomy involves the removal of the lamina, the back portion of a spinal bone in the lower back. This creates more room within the spinal canal.
Your health care provider may suggest:
Integrative medicine and alternative therapies may be used with conventional treatments to help you cope with spinal stenosis pain. Examples include:
You might be referred to a doctor who specializes in disorders of the nervous system (neurologist). Depending on how severe your symptoms are, you may also need to see a spinal surgeon (neurosurgeon or orthopedic surgeon).
Before the appointment, you might want to prepare a list of answers to the following questions:
Your health care provider may ask some of the following questions: