Spinal stenosis is a condition in which the spinal canal narrows. This puts pressure on the spinal cord and the spinal nerves, leading to low back pain that radiates down into the legs and buttocks. It can be caused by herniated discs, arthritis, spinal injury, tumors, or bone disease. It is most common in older adults, resulting from a combination of aging and degeneration of the spine.
The most common symptoms are lumbar pain, numbness, or tingling in the neck, shoulders, arms, buttocks, back, or thighs. Weakness in one part of the leg or arm is also common. When stenosis is located in the lower back, it can also affect posture, gait, and bladder and bowel function. While many patients note some relief when sitting and leaning forward, standing and walking may bring on severe pain and weakness
Causes and Risk Factors
Arthritis is the most common cause of spinal stenosis due to degeneration. Anything that narrows the spinal canal makes the spinal cord and nerves vulnerable to pressure that causes irritation and inflammation. Other conditions that can narrow the spinal canal include herniated discs, arthritis, swollen ligaments, bone spurs, and spondylolisthesis. A small number of people who have a narrow spinal canal from birth are at risk for developing stenosis earlier in life.
Diagnosing spinal stenosis requires several tests. In addition to a detailed medical history, your doctor will complete a physical exam and diagnostic tests such as x-ray or magnetic resonance imaging (MRI). These tests can help the physician rule out other conditions and provide you with an accurate diagnosis.
Back pain from spinal stenosis may be alleviated with conservative care, such as anti-inflammatory pain medications, physical therapy, steroid injections, acupuncture, or chiropractic manipulation. These nonsurgical treatments do not improve the narrowing of the spinal canal, but they can relieve pain, especially in early stages.
When surgery is necessary, the main goal is to remove the pressure on the nerve roots in the lumbar spinal canal. There are two main surgical options to consider: laminectomy or spinal fusion. Your neurosurgeon will discuss the advantages and disadvantages of both with you. In a laminectomy, your surgeon will enlarge the tube of the spinal canal and remove any bone spurs that are pushing into the nerve roots to decompress the lumbar spine. If arthritis has progressed to cause instability in the spine, spinal fusion may be performed to eliminate motion between painful vertebrae and fuse them together into one solid bone.