Spinal Stenosis
Spinal stenosis is a condition that occurs most often in the lumbar and cervical regions of the spine, causes the narrowing of space within the spine, and results in increased pressure being placed on the nerves traveling through the spinal column.
Some people with spinal stenosis may not have symptoms. Others may experience pain, tingling, numbness and muscle weakness; symptoms of spinal stenosis can worsen over time.
Causes of Spinal Stenosis
Spinal stenosis occurs in the spinal canal. While the condition may form naturally in people who are born with smaller spinal canals, the condition most frequently occurs as a result of something causing the space in the spinal column to narrow; causes of spinal stenosis may include:
- Bone Spurs. Osteoarthritis occurring in the spine often results in bone spurs developing in the area of the spinal column. These bone spurs narrow the diameter of the spinal column and increase the likelihood of developing spinal stenosis.
- Herniated or ruptured discs. As discs in the spine age, they become more dry and brittle. A disc developing a tear, or rupturing, can result in the inner material to protrude from the disc and cause increased pressure, inflammation, and irritation on the spine.
- Thickening of ligaments. As we age, it is common for the ligaments in the spine to stiffen, thicken, and become less flexible; as this happens, it is fairly common for these ligaments to push on the spinal canal and cause stenosis.
- Injuries to the Spinal Canal. Traumatic injuries resulting in fractures or dislocation in the spine can result in damage, swelling, and narrowing to the spinal canal, which results in increased pressure to the nerves of the spine.
Symptoms
Spinal stenosis is most commonly caused by wear-and-tear changes in the spine related to osteoarthritis, with the type of spinal stenosis classified by where the condition occurs on the spine. Specifically, there are two types of spinal stenosis:
- Cervical stenosis, where narrowing of the spine is located in the cervical, or neck, area.
- Lumbar stenosis, where narrowing of the spine is located in the lumbar, or lower back area. Lumbar stenosis is the most commonly reported type of spinal stenosis.
Evidence of spinal stenosis may be revealed through MRI or CT scans, but may be asymptomatic in nature. As symptoms develop, they tend to be mild at the start and become progressively worse over time; symptoms of the condition often depend on the specific nerves being affected and the location where the condition occurs. Specifically, symptoms of spinal stenosis include:
Cervical stenosis
- Tingling and/or numbness in the feet, hands, arms or legs
- General weakness in upper extremities, specifically the arms or hands
- Issues arising with coordination and balance, especially while walking
- General neck discomfort, pain, or irritation
Lumbar stenosis
- Tingling, numbness, or irritation in the leg or foot
- General weakness in lower extremities, specifically the feet or legs
- Pain, discomfort, or cramping in the legs and feet, especially while standing for extended periods of time
- General back discomfort, pain, or irritation
Diagnosis
Spinal stenosis is most often diagnosed after your doctor conducts a complete physical exam and a detailed review of your medical history; your physician might also order a series of medical imaging tests, including x-rays, MRI, or CT, to further identify the exact cause contributing to observed symptoms.
Possible Treatments
Treatment of spinal stenosis is often dependent of the severity of symptoms and the exact location of the condition. In situations where there is little to no pain or discomfort, treatment might consist of OTC pain medication and follow-up appointments to monitor your condition. In cases that are more severe, your doctor might recommend prescription medication to alleviate pain and reduce inflammation in the affected area; physical therapy to increase strength and flexibility in the muscles around the spine; steroid injections to reduce pain and inflammation; decompression procedures; and in severe cases, surgery, including laminectomy, foraminotomy, laminoplasty, or spinal fusion.
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