What causes spinal stenosis?

Spinal stenosis is a narrowing of the spinal column that results in pressure on the spinal cord or a narrowing of the openings (called neural foramina) where spinal nerves leave the spinal column.

Stenosis typically progresses with age and may worsen over time. Most individuals who experience stenosis are over the age of 50. Lumbar stenosis, which is a more common form of the condition, causes a compression of the spinal nerve roots in the lower back. Cervical stenosis, however, is more serious because it may involve compression of the spinal cord itself.

Pathological causes may include herniated or degenerative discs, spinal tumors, acute spinal injury or an overgrowth of bone.

What are the symptoms of stenosis?

• Sciatica (a numbness, tingling or persistent weakness in the leg or foot) may be caused by cervical stenosis. Patients with cervical stenosis may also experience incontinence in their bladder or bowel.
• Lumbar stenosis can cause various levels of pain, cramping or discomfort in the legs during long periods of standing or walking. This discomfort may subside when seated or bending forward (leaning over a shopping cart, for example.)
• Muscle spasms may also occur.

How is spinal stenosis diagnosed?

An imaging test, such as an X-ray, MRI or CT myelogram, will assist a physician in diagnosing spinal stenosis. The symptoms of stenosis are fairly common in other back disorders, so while a physical examination and review of medical history are necessary, those steps alone are often not enough to confirm stenosis as the source of pain or weakness.

How is spinal stenosis treated?

Your physician will counsel you on various forms of treatment based on the severity of symptoms associated with stenosis. The source location of stenosis may also dictate which treatment options are recommended. Anti-inflammatory medications such as over-the-counter NSAIDs (ibuprofen or naproxen) may help reduce pain and inflammation. Muscle spasms may be relieved with relaxants.

Steroid injections and physical therapy may also help relieve the symptoms associated with stenosis. Also, your physician or therapist will likely provide home exercises and posture tips to help strengthen your back and reduce pain. Most patients respond well to non-surgical treatment.

For more significant cases of stenosis where a patient is severely debilitated as a result of his or her condition, surgery may be helpful in relieving some of the pressure on the spinal cord or nerve roots by creating more room in the affected area. A laminectomy, for instance, removes the lamina (back part of vertebra) to help increase space and relieve pressure. In some cases, a spinal fusion may be necessary to help strengthen multiple vertebrae.