Spinal stenosis
What is spinal stenosis?
The bones of your spinal column (vertebrae) protect the nerves that come out of your brain and travel down your back. These nerves form your spinal cord. Nerve roots are the large nerves that branch out from your spinal cord. They go out of your spinal column between each vertebra.
Spinal stenosis is a narrowing in one or more areas of the spinal column. This narrowing causes pressure. The pressure can be:
- On the spinal cord itself. This is called central spinal stenosis.
- On the spinal nerves as they leave the spinal column. This is called foraminal stenosis.
What is spinal stenosis?
Spinal stenosis can develop as a person ages. The disks between your vertebrae that help separate and cushion your spinal bones become drier and start to shrink. Ligaments that run up and down your spine can become stiff or hard. Boney growths, called bone spurs, can form on your spinal bones and put pressure on the nerves of your spine.
Spinal stenosis may also be called spondylosis or degenerative spine disease.
Other problems can also cause spinal stenosis, including:
- Tumors
- Infections
- Bone diseases such as Paget disease of bone
- Birth defects in the spine
- Fractures
- Your anatomy -- if you were born with a smaller canal
What are the symptoms of spinal stenosis?
Symptoms often get worse slowly over time. Most often, symptoms will be on one side of the body, but may involve both legs.
Symptoms include:
- Numbness, cramping, or pain in the back, buttocks, thighs, or calves, or in the neck, shoulders, or arms.
- Weakness in part of one leg. You may have a hard time standing on your toes or heels on one side.
You are more likely to have symptoms of spinal stenosis when you are standing, sitting up straight, or walking. Symptoms often lessen or go away when you sit down or lean forward. Because of their symptoms, most people with spinal stenosis can't walk for long without having to stop. Leaning over while using a shopping cart or a walker can help you feel better and walk for longer.
People with spinal stenosis may be able to ride a bicycle with little pain since bike riding forces you to lean forward.
Serious symptoms of spinal stenosis that require medical attention right away include:
- Difficulty walking or losing your balance when you walk.
- Problems controlling your urine or bowel movements.
- Problems urinating or having a bowel movement.
How is spinal stenosis treated?
If your back pain does not go away completely, or if it gets worse at times, it's important to learn how to take care of your back. This can help prevent further back pain and help you avoid back surgery. Your doctor and other health care providers will help you manage your pain and teach you how to be as active as possible without hurting your back.
Most of the time, your provider will try to treat you without surgery. This involves using medicines for back pain, physical therapy, and lifestyle changes. Your provider may also give you a steroid injection to relieve pain for a limited time.
If you still have pain after moderate treatment, your provider may advise surgery to relieve the pressure on your nerves or spinal cord.
What to expect
Many people with spinal stenosis are able to stay active for many years. You may need to change some activities or how you work if you have spinal stenosis.
Spine surgery often provides full or partial pain relief. But if you had chronic back pain before surgery, you are likely to still have some pain afterward. Spinal fusion is unlikely to take away all your pain and other symptoms.
Changes that were caused by the pressure on your nerves may be permanent, even if this pressure is relieved during surgery.
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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