What Is Spinal Stenosis?

Spinal stenosis — also called vertebral stenosis — is a condition in which spaces in your spine become too narrow (the term “stenosis” refers to narrowing of any passage in the body). As a result, bones or other parts of the spine start pressing on your spinal cord and other nerves.

Although some people don’t experience symptoms, those who do may have pain, numbness, muscle weakness, and tingling in the neck or back.

Spinal stenosis can happen anywhere along your spine, and its causes and symptoms may be different depending on where the narrowing occurs. Stenosis usually occurs in the cervical region of the spine near the head and neck, or in the lumbar region in the lower back.

• Lower back pain
• Pain or aching that spreads down your back into your legs; it feels worse when standing or walking and better when you lean forward
• Cramping, numbness, or tingling in your feet and legs
• Muscle weakness in your feet and legs

Symptoms of spinal stenosis in the neck may include:

• Neck pain
• Tingling or numbness in your arms and hands
• Weakness in your arms and hands

Age-related changes to the spine are the main cause of spinal stenosis. Aging bones and ligaments of your spine may gradually get thicker and stiffer, leaving less space between them. Bone spurs that press on the spine and nerves may also develop.

• Osteoarthritis, which involves loss of cartilage in the joints, can trigger excessive bone growth, called bone spurs, that shrinks spinal spaces.
• Rheumatoid arthritis, which causes inflammation and enlargement of soft joint tissues, may also leave less room for the spine and nerves.
• Paget’s disease of bone, which causes excessive bone growth, can affect the spine and result in stenosis.
• Injuries such as herniated disks can also lead to spinal stenosis. Car accidents or other traumatic injuries may leave vertebrae misaligned, leaving less space for nerves.
• Spinal tumors or abnormal growths may press on the spinal cord or nerves, leading to symptoms of stenosis. This is uncommon.

To determine if you have spinal stenosis, your doctor will ask about your symptoms and do a complete physical exam in which they look for signs of spinal stenosis, such as numbness and weakness.

• X-Ray An X-ray of your back can show bone changes that may be narrowing the spaces in the spinal canal.
• Magnetic Resonance Imaging (MRI) An MRI creates a cross-sectional image of your spine that can detect where nerves in the spinal cord are under pressure. It can also reveal any damage to disks and ligaments.
• Computerized Tomography (CT) Scan If you can’t get an MRI, a CT scan can also create images of your spine. It combines X-ray images taken at different angles to produce a cross-sectional picture of your spine.

Medication Options

• Ibuprofen (Advil or Motrin) and other nonsteroidal anti-inflammatory drugs (NSAIDs) can offer short-term relief.
• Antidepressants, such as tricyclic antidepressants, can help ease chronic pain.
• Anti-seizure drugs such as gabapentin (Neurontin) and pregabalin (Lyrica) can decrease pain from damaged nerves.
• Opioids such as oxycodone and hydrocodone may be used for short-term pain relief; however, they are used cautiously since they may become habit-forming.

Steroid injections can also help with the pain (though they don’t cure spinal stenosis). Getting too many steroid injections can weaken bones and connective tissue, so your doctor will likely limit them to a few times a year.

Nonmedication Treatments

• Physical Therapy Your doctor may recommend physical therapy, especially if you’ve become less active due to the pain caused by spinal stenosis. Weak muscles can actually lead to more pain. Working with a physical therapist can help you build strength, become more flexible, and improve your balance. For those with severely limited movement, aquatic physical therapy may be a good option.
• Hot or Cold Packs Ice packs or hot packs applied to the neck may ease symptoms of stenosis in the cervical region (around the neck). They can also be used on the lower back.
• Weight Loss Losing weight may help ease symptoms of lumbar (lower back) stenosis by reducing the load your spine has to bear.

Surgery

• Laminectomy In this procedure, a surgeon removes a sizable part of one or more vertebrae to give nerves more room. This may require fusing vertebrae together, or implanting hardware to strengthen the spine.
• Laminotomy In this case, a surgeon removes a smaller portion of a vertebra to relieve some of the pressure.
• Laminoplasty This procedure involves attaching a metal hinge to part of a vertebra. It is only performed on the neck.
• Minimally Invasive Surgery Options short of spinal surgery include removing part of the ligament at the back of your lower spine to reduce pressure on the nerves, and inserting spacers between some of your vertebrae.

Complementary and Integrative Therapies

• Chiropractic Treatment Working with a chiropractor may provide some pain relief.
• Acupuncture Fine needles are used to stimulate specific locations on the body, which may reduce pain.

• Exercise regularly. Aerobic exercises such as walking, swimming, and cycling can help strengthen your back muscles and help keep your spine flexible.
• Protect your spine. Maintain good posture by sitting in a supportive chair and sleeping on a firm mattress. Avoid lifting heavy objects, or learn how to lift heavy objects safely.
• Maintain a healthy weight. Being overweight puts excess stress on your back and can cause spinal stenosis.

• Trouble walking due to numbness or weakness
• Loss of bowel or bladder control
• Sexual dysfunction
• Paralysis in your legs

Lumbar spinal stenosis can lead to cauda equina syndrome (CES), a very rare and serious issue where the cauda equina (a bundle of nerves attached to the bottom of the spine) is compressed and interrupts motor and sensory function in your lower body, including your bladder.

As noted above, the following conditions increase your risk of developing spinal stenosis:

• Osteoarthritis
• Rheumatoid arthritis
• Paget’s disease of bone

• Spinal stenosis is a narrowing of the spinal column that causes nerves to become compressed.
• It can cause pain, numbness, and tingling in your neck or lower back.
• Mild symptoms can be treated with stretching, hot and cold therapy, and over-the-counter pain relievers. Severe cases may need surgery.
• You can help keep your spine healthy by exercising, maintaining a healthy weight, and lifting heavy objects correctly.