Spinal stenosis symptoms & treatment

Spinal stenosis is caused by a narrowing of the open space in your spine (the spinal canal). When this canal is narrowed, it puts pressure on your spinal cord or the nerves of your spine, causing pain, numbness or weakness.

Aging is the most common cause of spinal stenosis. The gradual wear and tear on the spinal cord discs and joints causes the spinal canal to narrow. Other things that contribute to spinal stenosis are conditions such as arthritis, a bulging disc or thickening of the ligaments in the back.

Stenosis can happen in any area of your spine, although it most often occurs in the neck (cervical spinal stenosis) and the lower back (lumbar spinal stenosis).

Symptoms of spinal stenosis

You may find that spinal stenosis symptoms occur on one side of your body and then gradually get worse over time. The location of your pain depends on where the narrowing of your spine is located in your back. Spinal stenosis symptoms may include:

• Numbness or weakness in your legs, thighs or feet
• Pain in your neck, shoulders, arms, back, buttocks, thighs or calves
• Bowel or bladder problems
• Loss of sexual function
• Poor balance when walking
• Partial or complete leg paralysis (in severe cases)

Your symptoms may be relieved when you bend forward, sit or lie down. Symptoms may also improve when you walk uphill and worsen when you walk downhill.

You can rely on our team for expert, compassionate care for all these symptoms. We’ll find the cause of your back pain so we can treat it and help you feel better.

Causes of spinal stenosis

The most common cause of spinal stenosis is aging – people 50 and older are the most likely to experience it.

Here’s what happens: Your spine consists of bones separated by discs. These discs are made of a jelly-like, squishy substance, and as you age, the discs lose water. At the same time, growths called bone spurs form on the surface of the bone. These changes eventually cause the spine to narrow.

Spinal stenosis may also be affected by other medical conditions, including:

• Arthritis
• Scoliosis
• Herniated discs
• Paget’s disease – a bone disease that causes the bones to weaken
• Spinal tumors – growths that can form inside the spinal cord
• Inflammatory spondyloarthritis, which describes diseases that involve your joints and the areas where ligaments and tendons attach to bone

Diagnosis of spinal stenosis

Diagnosis begins with performing a thorough evaluation. We’ll ask you about your stenosis symptoms and medical history. You’ll be asked about the exact location of the pain and whether it also travels down the arms, back or legs. We’ll ask you to describe how the pain feels (e.g., aching, burning or tingling), tell us about how long you’ve been having the pain and about anything you've done to treat your pain.

Some of the tests we perform may include:

• Performance exam: We may ask you to stand, sit, walk, bend forward, bend sideways and bend backward. We may also ask you to lie down and lift your legs straight up.
• Imaging scans: CT scans or MRI scans detect damage in your spinal canal. Another test we may use is a myelogram, where we inject a dye into your spine to make it easier to see the test results. X-rays can also help rule out other injuries that may be causing your symptoms.
• Electromyography (EMG): Stenosis sometimes puts pressure on the nerves in the back, damaging or irritating them. This test measures the electrical activity of your muscles to identify nerve damage or irritation.
• Bone scan: These scans help rule out other causes of your pain, such as tumors, fractures or arthritis.

Comprehensive spinal stenosis treatment

Whether you have mild or severe stenosis, we’ll discuss your treatment options with you. Your health goals and personal preferences are an important part of our plans.

We take a conservative approach to treatment and usually recommend nonsurgical treatments first. Here are some self-care methods you can try.

• Applying ice packs
• Applying heat
• Stretching exercises
• Warm baths or showers
• Nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin and ibuprofen to relieve pain and inflammation

Nonsurgical treatments

Some of the nonsurgical treatments we offer to help manage symptoms and relieve pain include:

• Medications, like NSAIDs or prescription medications to relieve pain and inflammation
• Physical therapy exercises to help restore strength and function
• Integrative medicine methods like chiropractic care and acupuncture
• Cortisone injections to lessen swelling and inflammation

Regular exercise helps you maintain strength and range of motion, which are vital for your quality of life. We’ll help you find exercises to keep you moving without worsening your symptoms.

Surgical treatments

If nonsurgical spinal stenosis treatment doesn’t work for you or works only temporarily, we’ll discuss options for spine surgery. Lumbar spinal stenosis is the most common diagnosis among people who undergo spine surgery who are older than 65.

Whenever possible, we use minimally invasive surgical methods, which target only the affected area to protect the healthy tissue. This usually leads to easier, more comfortable recoveries.

Some of the most common surgeries we perform include:

• Laminectomy, to remove the lamina (a part of the vertebrae) and create more space in the spinal canal
• Foraminotomy, which enlarges the area where the spinal nerve root exits the spinal canal
• Spinal fusion procedures, to connect the vertebrae that are causing pain so they no longer move around