Spinal Stenosis

Spinal Stenosis: Overview

Spinal Stenosis is a narrowing of the spaces within the spine. These spaces include the center of the spine through which the spinal cord passes, the canals through which nerves branch out from the spine, and also the space in between the vertebrae.

When any of these spaces narrows, pressure can be exerted on the spinal cord or on nerves, and this can be a source of pain. This condition most commonly affects men and women over 50 years old.

Causes

Aging

Due to the following changes which occur as we get older, aging is the most common cause of spinal stenosis:

• The bands of tissue that support the spine may get thick and hard
• Bones and joints may grow larger in size
• Bone spurs may develop and protrude from the surfaces of the vertebrae

Arthritis

Two types of arthritis have been attributed to the development of this condition:

Osteoarthritis

• Mostly afflicts those in middle age and older
• This is most prevalent type of arthritis
• Can affect numerous joints throughout the body
• Can degrade the cartilage that keeps the joints in place
• Can cause bone spurs and activate problems with joints

Rheumatoid Arthritis

• Tends to afflict individuals at a younger age than osteoarthritis
• Can cause joint swelling
• Can affect the vital organs and other systems of the body
• It is not one of the more common causes of spinal stenosis
• Can cause severe damage in the body, particularly to joints

Other Causes

• Injuries
• Tumors of the spine
• Paget’s disease (a bone disease)
• Too much fluoride in the body
• Calcium deposits on the ligaments in the spine
• Inherited conditions such as being born with scoliosis or a small spinal canal

Symptoms

• Back or neck pain
• Pain, numbness, weakness, or cramping in the arms or legs
• Pain which travels down the leg
• Problems with the feet

A very rare, extremely serious type of spinal stenosis is called cauda equina syndrome. Pressure on nerves in the lower back from this syndrome may cause:

• Loss of bladder or bowel control
• Difficulty having sex
• Pain, weakness, or loss of feeling in one or both legs

Loss of bowel or bladder control, or loss of feeling in the legs signals a serious problem requiring medical care. Call your doctor immediately.

Diagnosis

In addition to a complete physical examination, your physician may order one or more of the following tests to determine the presence of stenosis:

• Standard X-rays
• Magnetic Resonance Imaging (MRI) – This technology creates pictures of your spine using radio waves
• CAT Scan – Computerized Axial Tomography, or CAT scan, is a specialized type of x-ray that provides your physician with a more detailed image of your spine
• Myelogram – During this test, your physician injects liquid dye into your spinal column in order to make more visible the conditions of the spine
• Bone Scan – Radioactive material is put into the body to show where bone is breaking down

Treatment

Depending on the symptoms, your physician may refer you to one or more of the following specialists:

• Rheumatologist – A physician who treats arthritis and related conditions
• Neurologists and Neurosurgeons - Physicians who treat diseases and disorders related to the nervous system
• Orthopedic Surgeon – A physician who treats conditions of the joints, bones, and ligaments
• Physical Therapists – PTs specialize in exercise rehabilitation

Non-Surgical Treatment

There are numerous nonsurgical treatments for spinal stenosis including:

• Pharmaceuticals to reduce swelling and to relieve pain
• Reduction of certain activities
• Exercises and/or physical therapy
• A stabilizing brace for the spine
• Chiropractic
• Acupuncture

Considerations for Surgery

It is unlikely that surgery would be recommended by your physician unless one or more of the following were part of your condition:

• You had symptoms that seriously impaired your ability to walk
• You were experiencing loss of bladder or bowel control
• The stenosis was affecting your nervous system

For more in-depth information...

Return to Top of Spinal Stenosis

Go to Lower Back Pain Answers Home Page