What is spinal stenosis?
The spine is a column of bones called vertebrae that provide stability and support to your upper body. It enables you to turn and twist. Spinal nerves run through openings in your vertebrae and conduct signals from your brain to the rest of your body. These nerves form your spinal cord.
The surrounding bone and tissues protect the nerves in your spinal cord. If they’re damaged or impaired, it can affect functions such as walking, balance, and sensation. Spinal stenosis is a condition in which spaces in the spinal column narrow, compressing the spinal cord. This process is typically gradual. It can occur anywhere along the spine.
What are the symptoms?
The symptoms of spinal stenosis typically progress over time, as nerves become more compressed. You might experience:
- leg or arm weakness
- lower back pain while standing or walking
- numbness in your legs or buttocks
- balance problems
Sitting in a chair usually helps relieve these symptoms. However, the symptoms may return during periods of standing or walking.
What are the causes of spinal stenosis?
The most common cause of spinal stenosis is aging. As you age, tissues in your spine may start to thicken, and bones may get bigger, compressing the nerves.
Certain health conditions may also contribute to spinal stenosis, including:
- Achondroplasia. This inherited condition interferes with bone formation in the spine, as well as other parts of the body.
- Ankylosing spondylitis. This is a type of arthritis that causes chronic inflammation in the spine, which can lead to the growth of bone spurs.
- Congenital spinal stenosis. This is a birth defect in which the spinal canal is naturally narrow.
- Ossification of the posterior longitudinal ligament (OPLL). In this condition, calcium deposits form on the ligament that runs through the spinal canal.
- Osteoarthritis. In this type of arthritis, the cartilage that cushions joints breaks down. It can affect the cartilage between vertebrae and may also cause bone spurs to grow in the spine.
- Paget’s disease of the bone. This chronic condition causes bones to get weaker and grow larger than usual.
- Rheumatoid arthritis. This type of arthritis involves chronic inflammation, which can cause bone damage and bone spurs to develop.
- Scoliosis. This abnormal curving of the spine may result from certain genetic conditions, neurological abnormalities, or unknown causes.
- Spinal injuries. Slipped discs or bone fractures may cause vertebrae or bone fragments to put pressure on nerves in the spine.
- Spinal tumors. These abnormal tissue growths may develop in the spinal canal, trigger inflammation, and cause changes in the surrounding bone.
How is spinal stenosis diagnosed?
If you have symptoms of spinal stenosis, your doctor will start by taking a medical history, performing a physical exam, and observing your movements.
Your doctor may also order tests to check for signs of stenosis, such as:
- X-ray, MRI scan, or CT scan to view images of your spine
- electromyelogram to check the health of spinal nerves
- bone scan to look for damage or growths in your spine
What are the treatment options for spinal stenosis?
First-line treatments
To treat spinal stenosis, your doctor will likely start by prescribing medication.
Cortisone injections into your spinal column can reduce swelling. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help ease pain.
Your doctor may also recommend physical therapy to help strengthen and stretch your muscles.
Surgery
If you have severe pain or weakness, your doctor may recommend surgery to treat spinal stenosis.
They may also prescribe surgery if the condition is affecting your ability to walk, control your bowel or bladder, or do other routine activities.
Several types of surgery are used to treat spinal stenosis:
- Laminectomy is the most common type of surgery. A surgeon removes part of the vertebrae to provide more room for the nerves.
- Foraminotomy is used to widen the part of the spine where the nerves exit.
- Spinal fusion is typically performed in more severe cases, especially when multiple levels of the spine are involved. Bone grafts or metal implants are used to attach the affected bones of the spine together.
Are there other ways to cope with spinal stenosis?
You may find some relief from symptoms of spinal stenosis with one or more of these home remedies or complementary therapies:
- heat therapy, in which you use a heating pad, warm towel, warm bath, or other heat source to relax stiff muscles
- cold therapy, in which you apply a towel-wrapped cold pack or ice to swollen areas to relieve swelling and pain
- stretching and strengthening exercises
- acupuncture
- massage
Learn more about home remedies for back pain.
What is the long-term outlook for people with spinal stenosis?
Many people with spinal stenosis lead full and active lives. However, you may need to adjust your exercise routine or other day-to-day activities to help manage the symptoms of spinal stenosis. Your doctor may prescribe medications, physical therapy, or surgery treatments to relieve pain and other symptoms. You may experience residual pain after treatments. Talk with your doctor to learn more about your treatment options and outlook with spinal stenosis.
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