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Spinal Stenosis: Symptoms, Treatment, Outlook

Published February 12, 2021
| Written By SpineNation Editorial Staff   | Medically Reviewed by Benjamin Bjerke, M.D.
Tags:  Spinal Stenosis
Spinal stenosis is a narrowing of the open spaces in the spine, which can put pressure on the spinal cord or the spinal nerves as they exit the spine.

Causes of Spinal Stenosis

The spine is made up of 33 bones (vertebrae) that are connected by ligaments. The spinal cord, which is made up of spinal nerves, runs along the spine through an opening called the spinal canal. The spinal nerves exit the spinal canal through other openings between the vertebrae.

Spinal stenosis is a narrowing of the spinal canal or the openings that the nerves exit through. When this happens, the spinal cord or spinal nerves can become compressed, which causes symptoms such as weakness, numbness, or pain in the legs.

Some children are born with spinal stenosis or develop it early in life. But this condition more often occurs later in life, what’s known as acquired spinal stenosis. The causes of acquired spinal stenosis include:

  • Age-related wear and tear of the spine
  • Injury to the spine
  • Herniated (or ruptured) disc
  • Osteoarthritis of the spine
  • Growth of bone inside the spinal canal
  • Overgrowth or hardening (calcification) of the ligaments that support the spine
  • Tumors in the spine

What are the Symptoms of Spinal Stenosis?

Symptoms of spinal stenosis depend on which part of the spine is narrowed, but include:
  • Pain in the neck or back. These generally get worse when doing certain activities, in particular those that require standing or walking.
  • Numbness, tingling, or weakness in the arms
  • Numbness, tingling, weakness, or heaviness in the legs
  • Pain in the lower back, buttocks, thighs, or legs
  • Balance problems or frequently falling
More serious cases of spinal stenosis can cause symptoms such as:
  • Difficulty with bowel movements or urination
  • Partial or complete loss of feeling in the leg
  • Difficulty having sex
Symptoms may be relieved when bending forward, particularly the ones that occur while standing or walking. This is because bending forward creates more space in the spinal canal, which can decrease the pressure on the nerves.

Some people with spinal stenosis may also have no symptoms at first, but can develop suddenly. In addition, the same amount of narrowing can cause different symptoms in different people.

Risk Factors

Certain factors increase the chance of developing spinal stenosis, including:
  • Older age
  • Other spinal conditions such as herniated disc or degenerative disk disease
  • History of damage to the spine
  • Pre-existing congenital or developmental spinal stenosis

Is Spinal Stenosis Common?

Spinal stenosis occurs in about 1 in 1000 people 65 years or older, and about 5 in 1000 people 50 years or older. So in the United States, between 250,000 and 500,000 older adults have this condition.

How is Spinal Stenosis Diagnosed?

The following may be used to diagnose spinal stenosis:
  • Medical history and physical exam
  • Blood and urine tests to look for signs of another condition that may be causing the symptoms
  • Imaging tests of the spine such as X-ray, computerized tomography (CT) scan, or magnetic resonance imaging (MRI)
  • Nerve conduction test to see how fast the electrical impulses move through the nerve

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Treatment

Non-surgical treatments are generally tried first, such as:
  • Physical therapy to improve posture and mobility. Better posture can reduce the pressure on the nerves.
  • Over-the-counter pain relievers, such as acetaminophen, or ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs). These also reduce swelling, or inflammation, that is irritates the nerve.
  • Prescription pain relievers may be used in some cases, but usually only for a short time due to the more severe side effects.
  • Losing weight, if needed, to reduce stress on the spine.
  • Wearing a back brace or other supportive device.

Surgery 

If these treatments don’t help, surgery may be recommended. The type of surgery depends on the underlying problem that is causing the compressed nerve. This may include:
  • Diskectomy. Removal of part of all of a damaged disk.
  • Laminectomy. Removal of part of a vertebra.
  • Spinal fusion. Stabilizing the spine using bone or bone-like material, along with metal spacers, screws, or rods.

Prevention

Spinal stenosis cannot always be prevented, but you can reduce your risk of having worse symptoms by keeping your spine healthy. This includes:
  • Maintain a healthy weight to reduce stress on the spine.
  • Eat a healthy diet that includes lots of fruits, vegetables, whole-grains, and lean protein.
  • Exercise regularly, including two or more days a week of core- and back-strengthening activities such as Pilates, yoga, or weight lifting.
  • Practice good posture.

Outlook

Spinal stenosis will generally not go away without surgery. But in many cases, non-surgical treatments such as exercise, good posture, and physical therapy can help keep the symptoms from worsening and improve mobility. Clinical trials to explore treatment options for spinal stenosis are ongoing. Participants enable researchers to find ways to provide better patient care.

If spinal stenosis causes severe pain or interferes with daily activities, and isn’t helped by these non-surgical treatments, surgery may be needed.

Seek medical help right away if you experience any of the following:
  • New or increased pain in the neck or upper back
  • New or increased numbness or tingling in the back or legs
  • Pain, redness, or swelling in the arm or leg
  • Severe pain that doesn’t go away with an over-the-counter pain reliever
  • Dizziness
  • Blurred or double vision
  • Severe headache that worsens when you stand up
  • Nausea or vomiting

Conclusion

Spinal stenosis is a narrowing of the open spaces in your spine. This includes the spinal canal that runs along the spine and the spaces where the spinal nerves exit the spinal canal. This narrowing can put pressure on the spinal cord or nerves.

Symptoms of spinal stenosis include numbness, weakness, or pain in the neck, arms, back, or legs. Spinal stenosis can be caused by injury, age-related changes to the spine, tumors, or other spine conditions.

Many cases can be kept from worsening using non-surgical treatments such as physical therapy, exercise, weight loss, and practicing good posture. More severe cases may require surgery to reduce the pressure on the spinal cord or spinal nerves.
Updated: February 17, 2021
Disclaimer

Information provided within this article is for educational purposes and is not a substitute for medical advice. Those seeking specific medical advice should consult his or her doctor or surgeon. If you need to consult with a specialist, you may be able find a health care provider in our Specialist Finder. SpineNation does not endorse treatments, procedures, products or physicians.


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Contributors and Experts

Dr. Benjamin Bjerke is fellowship-trained in neurosurgery and orthopedic spine surgery and specializes in surgical procedures of the cervical spine as well as minimally invasive lumbar procedures.
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