Spinal stenosis is a condition affecting the spinal column. It causes a gradual narrowing of the spaces in your spine which can then start to compress your spinal cord as well as the sensitive nerve roots exiting each vertebra. These tightened spaces can gradually cause the spinal cord and related nerves to become irritated, or compressed which can then lead to back pain as well as other conditions like sciatica.
Spinal stenosis is a condition that tends to develop slowly, and many age-related cases are caused by osteoarthritis or simple wear and tear. A lot of people don’t notice any symptoms for a long time even though some changes might be seen on X-rays or other imaging tests if taken for another reason. Though some cases of spinal stenosis can cause pain, numbing, tingling, and possible weakness in the neck, back, arms, legs, hands, or feet.
Different Types Of Spinal Stenosis
There are different types of spinal stenosis depending on where the narrowing of the spinal column is most severe. They are lumbar canal stenosis of the lower back and cervical spinal stenosis affecting the neck.
With lumbar canal stenosis, the narrowing of the spinal canal tends to affect the other nerve structures that communicate with that canal. This is often due to changes associated with aging that decrease the size of the canal, including the movement of one of the vertebrae out of alignment.
As lumbar spinal stenosis advances, the narrowing of the spinal canal or the side canals that protect the nerves often results in a pinching of the nerve root of the spinal cord. This causes the nerves to become increasingly irritated as the diameter of the canal becomes narrower.
What Are The Symptoms Of Lumbar Spinal Stenosis?
Symptoms of lumbar canal stenosis often include pain, with numbness or weakness in the legs, groin, hips, buttocks, and also the lower back. Most sufferers complain that symptoms are worse when they walk or stand. Then noticeably decrease when lying down, sitting, or leaning slightly forward.
This can also include
- Pain in the lower back
- A heavy feeling in the legs, which may lead to cramping in one or both legs.
- Numbness or tingling in the buttocks, leg, or foot.
- Weakness in the leg or foot
- Loss of bowel or bladder control
What Are The Symptoms Of Cervical Spinal Stenosis?
Symptoms of cervical spinal stenosis in the neck typically manifest first as neck pain. Then it can progress to include numbness or tingling in the arm, hand, leg, or foot. Many people with advanced cervical spinal stenosis also experience weakness or clumsiness in the arm, hand, leg, or foot.
Some also notice problems with balance, and severe cases can lead to a loss of function in hands or even the loss of bladder or bowel control.
This can include:
- Numbness or tingling in the arm, hand, leg, or foot.
- Weakness or clumsiness in the arm, hand, leg, or foot.
- Problems with balance.
- Loss of function in hands, like having problems writing or buttoning shirts.
- Loss of bladder or bowel control (in severe cases).
Spinal Stenosis Causes
Several different things can cause spinal stenosis. Though all of them involved a gradual, yet pronounced change in the structure of the spine, causing a narrowing of the space around your spinal cord and nerve roots that exit through the spine. The spinal cord and/or nerve roots become compressed or pinched, which causes symptoms, such as low back pain and sciatica.
Some of the biggest contributing factors to spinal stenosis include:
- Bone overgrowth/arthritic spurs
- Age-related osteoarthritis
- Degradation of the cartilage in the spinal column
- Bone spurs on the vertebrae
- Paget’s disease
- Bulging discs/herniated disc
- Thickening in the ligaments that hold the spine together
- Spinal fractures and injuries occurring near the spine
- Spinal cord cysts or tumors
- Congenital defects
What Is Congenital Spinal Stenosis?
Congenital spinal stenosis is a genetic defect in which an individual is born. It causes a small spinal canal deformity that can put a person at risk for spinal stenosis as well as scoliosis.
Does Spinal Stenosis Result In Permanent Paralysis?
The good news is that spinal stenosis itself usually doesn’t cause paralysis. Unfortunately, if a spinal nerve or the spinal cord is compressed for a long period of time, it can result in permanent numbness, and/or paralysis is possible. Left unchecked the symptoms of spinal stenosis can have a debilitating effect on your overall quality of life.
Diagnosing Spinal Stenosis
Diagnosing spinal stenosis starts with your physician reviewing your medical history and performing a basic physical exam. This often involves feeling your spine, pressing on a different area to see if it causes pain.
The physician will likely ask you to bend in different directions to see if different spine positions bring on pain or other symptoms. They will then check your balance, to see how you move and walk. This is usually followed by evaluating your arm and leg strength.
If your physician suspects you have spinal stenosis or other structural issues they will likely refer you to have imaging tests via an MRI or a series of X-rays. This will help them to examine your spine and determine the exact location, type, and severity of the problem.
How Is Spinal Stenosis Treated
The treatment plan your physician puts forth will be based on the severity and underlying cause of your spinal stenosis symptoms. If your symptoms are mild, your healthcare provider may recommend some self-care remedies first. This might include things like
- Applying heat
- Applying cold packs
- Stretching exercises
- Oral medications
- Prescription pain relievers
- Muscle relaxants such as cyclobenzaprine
- Should these early intervention strategies not provide you with the relief you need your physician will likely recommend physical therapy, steroid injections, medications, and possibly surgery.
Surgery For Spinal Stenosis
The type of surgery that is best to treat your spinal stenosis will be based on the affected areas of the spine as well as the severity of your symptoms. This might include one or more of the following surgical procedures.
A Percutaneous Image-Guided Lumbar Decompression (PILD) can be performed on an outpatient basis to target the thickening of a specific ligament in the spinal column. It is performed through a tiny incision and requires no general anesthesia and no stitches.
A Laminectomy Decompression surgery might also be needed to remove the lamina, which is a portion of the vertebra. During this procedure, some ligaments and bone spurs may also be removed. The procedure makes room for the spinal cord and nerves, relieving your symptoms.
Foraminotomy is a surgical procedure that might be necessary to address the area in the vertebrae where the nerve roots exit. This typically calls for removing bone or tissue from this area to provide more space for the nerve roots.
Spinal Fusion might be needed if you have radiating nerve pain caused by spinal stenosis. Especially if your spine is not stable and other treatment options have been fruitless. Just bear in mind that a spinal fusion surgery permanently joins (fuses) two vertebrae together. A laminectomy is usually performed first and the bone removed during this procedure is used to create a bridge between two vertebrae, which stimulates new bone growth. The vertebrae are held together with screws, rods, hooks, or wires until the vertebrae heal and grow together. It can take up to 6 to 12 months for the fusion area to fully heal.