Spinal Stenosis at a Glance

• Spinal stenosis is a narrowing of the open spaces within the spine. This can put pressure on the spinal cord and the nerves.
• Spinal stenosis occurs most often in the lower back or the neck, and is a common and very treatable condition.
• Common symptoms include difficulty walking, back pain, numbness, and weakness.
• Treatments include physical therapy, medication and numerous procedures, including nerve blocks and spinal surgery.

Causes of Spinal Stenosis

Spinal stenosis is often caused by every day wear-and-tear changes in the spine related to aging. It may also occur when something happens to compress the available space within the spine.

Causes of spinal stenosis can include:

• Herniated discs: The cushions between the vertebrae dry out with age. Cracks in the disc’s exterior allow some of the inner material to escape and press on the nerves or spinal cord.
• Thickened ligaments: Ligaments may become stiff and thick, and can bulge into the spinal canal.
• Overgrowth of bone: Bone spurs can form due to wear and tear on the spinal bone. These can grow into the spinal canal.
• Spinal injuries: Trauma to the spine may damage the contents of the spinal canal. Swelling of adjacent tissue after back surgery can also put pressure on spinal cord or nerves.
• Tumors: Abnormal growths that have formed within the spinal cord, within membranes that cover the spinal cord or the space between the vertebrae and spinal cord.

Symptoms of Spinal Stenosis

Some people have no symptoms of spinal stenosis, and it is revealed through diagnostic imaging. When symptoms do occur, they often worsen gradually over time. Depending on the location of the stenosis, symptoms will vary.

Neck

Narrowing in the cervical spine may cause weakness, tingling or even numbness in the arms, hands, leg or foot. Sometimes, nerves to the bowel or bladder can be affected and lead to incontinence.

Lower Back

Compressed nerves in the lower part of the spine may cause cramping or pain in the legs after standing or walking. The pain may ease when sitting down or bending forward.

Treatment of Spinal Stenosis

Treatment depends on the location and severity of the stenosis. Treatment could include:

Medication

Medication can help to control pain associated with spinal stenosis. These medications may include:

• Over-the-counter medications to relieve pain and reduce inflammation.
• Antidepressants can help to ease chronic pain.
• Muscle relaxants can calm muscle spasms.
• Opioids can reduce pain but can be habit forming.
• Anti-seizure medications can be used to reduce pain caused by damaged nerves.

Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.

Therapy

Physical therapy can assist in building strength and endurance, and can help to improve balance and stability.

Steroid Injections

Steroid injections can help reduce inflammation and relieve pressure. However, repeated steroid injections can weaken nearby tissue and bone, so must be used sparingly.

Surgery

Back surgery may be considered if more conservative treatments have failed or if symptoms are disabling. The goal of surgery is to relieve pressure on the nerve roots and spinal cord.

Surgery is helpful in most cases. In some cases, however, some patients may experience no change in symptoms or symptoms may become worse.