Things to know about spinal stenosis
Spinal stenosis is caused by the gradual narrowing of the spinal canal, resulting in painful pressure and compression on the spinal cord and nerves.
While spinal stenosis is not a serious condition in the initial stages, it can lead to serious and permanent damage if it becomes advanced or remains untreated. Permanent damage may include the following:
- Bowel and bladder incontinence
- Permanent disability
While spinal stenosis can occur in young adults, it is more common among people over the age of 60, and women are more likely to be affected than men.
What are the symptoms of spinal stenosis?
Spinal stenosis creates pressure on nerves that can cause neck and lower back pain, adversely impacting your ability to perform day-to-day activities. Symptoms start gradually due to inflammation and compression of the nerves or both and worsen over time.
Symptoms may include the following:
- Pain in the legs, calf muscles, or buttocks that is aggravated by standing
- Pain that radiates to one or both of the thighs (sciatica)
- Pain that improves by sitting, lying down, or bending forward
- Weakness, numbness, and tingling in the legs
- Severe back pain that worsens when standing for long periods of time
- Cramping in the calf muscles when walking
- Foot drop (weakness of the foot when walking)
- Decreased sensation in the feet
- Loss of bladder or bowel function, severe numbness, and unbearable pain and weakness in the legs (in rare cases)
What are the different types of spinal stenosis?
Spinal stenosis is broadly classified into two types:
- Cervical stenosis: Narrowing occurs in the neck
- Lumbar stenosis: Narrowing occurs in the lower back (most common)
How do doctors diagnose spinal stenosis?
Your neurosurgeon can confirm a diagnosis of spinal stenosis based on your symptoms, medical history, and physical examination. They may recommend certain tests to rule out other conditions:
- X-rays: Visualizes bony structure and spine alignment as well as intervertebral discs
- MRI scan: Visualizes the spinal cord, nerve roots, enlargements, degenerative changes, and tumors
- Computed tomography scan: Multiple X-rays at different angles that help locate the shape and size of the spinal canal
- Myelogram: Contrast dye is injected into the cerebrospinal fluid (spinal fluid space) to outline the spinal canal and nerve roots
What is the treatment for spinal stenosis?
Nonsurgical treatments may involve the following:
- Lifestyle changes such as exercise and weight loss
- Medications such as over-the-counter painkillers, analgesics, and antidepressants
- Physical therapy, which can help improve mobility and flexibility
While some people have intermittent pain or numbness when walking, others are so severely impacted that surgery is inevitable.
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"Lumbar Spinal Stenosis." American Association of Neurological Surgeons: <https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Lumbar-Spinal-Stenosis>.
"Lumbar Spinal Stenosis." Johns Hopkins Medicine. <https://www.hopkinsmedicine.org/health/conditions-and-diseases/lumbar-spinal-stenosis>.
"Spinal Stenosis." American College of Rheumatology. <https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Spinal-Stenosis>.
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