Spinal Stenosis
Spinal stenosis is a narrowing of the spaces within the spine that can place pressure on the spinal cord or nearby nerve roots. Depending on where the narrowing occurs, patients may experience neck or back pain, numbness, tingling, weakness, balance problems or pain that travels into the arms or legs.
What Is Spinal Stenosis?
The spine contains passageways for the spinal cord and nerve roots. When these spaces become narrower, nearby neurological structures can become compressed or irritated. The resulting symptoms depend on both the location and severity of the narrowing.
Narrowing Can Affect Nerves Differently
Some patients have spinal narrowing visible on imaging but few symptoms. Others develop significant pain, numbness, weakness or difficulty walking when the available space around a nerve or the spinal cord becomes too limited.
The Location of the Narrowing Matters
Spinal stenosis most commonly develops in the cervical spine or lumbar spine, and symptoms can differ considerably between the two.
Cervical Spinal Stenosis
Cervical stenosis occurs in the neck. Compression of the spinal cord or cervical nerve roots can cause neck pain, arm or hand numbness, weakness, loss of dexterity and, in more severe cases, problems with walking or balance.
Lumbar Spinal Stenosis
Lumbar stenosis occurs in the lower back and is the more common form. It can cause lower back pain, leg pain, tingling, weakness or heaviness, particularly with standing and walking.
How Spinal Stenosis May Affect the Body
Symptoms depend on which nerves are being compressed and may gradually become more noticeable as narrowing progresses.
Common Symptoms May Include:
What Can Narrow the Spinal Canal?
Spinal stenosis is often caused by age-related changes, although several conditions can reduce the amount of space available for the spinal cord or nerve roots.
Bone Spurs
Osteoarthritis can cause extra bone growth around spinal joints. These bone spurs may extend into the spinal canal or nerve openings and reduce available space.
Herniated or Bulging Discs
Discs can bulge or herniate into the spinal canal, creating additional pressure on nearby nerves.
Thickened Ligaments
Ligaments that help support the spine can become thicker and stiffer over time, contributing to narrowing of the spinal canal.
Spinal Injury
Fractures, swelling, displacement or other changes following trauma can reduce the space surrounding the spinal cord and nerves.
Other Conditions Can Also Reduce Space Around the Nerves
A comprehensive evaluation can help determine which spinal structures are responsible for the narrowing and the patient's symptoms.
Degenerative Disc Disease
Loss of disc height can change spinal mechanics and reduce space within the nerve openings between vertebrae.
Spondylolisthesis
Slippage of one vertebra relative to another can alter alignment and contribute to narrowing around spinal nerves.
Spinal Tumors
Rarely, abnormal growths within or around the spinal canal can occupy space and compress neurological structures.
Congenital Narrowing
Some people are born with a naturally smaller spinal canal and may develop symptoms earlier when age-related changes occur.
Why Can Standing and Walking Make Leg Symptoms Worse?
A characteristic feature of lumbar spinal stenosis is discomfort that develops with prolonged standing or walking.
Neurogenic Claudication
Lumbar stenosis can cause aching, heaviness, numbness or weakness in the legs after standing or walking. This pattern is called neurogenic claudication and results from reduced space around the lumbar nerves.
Why Leaning Forward May Help
Bending slightly forward can temporarily increase space within parts of the lumbar spine. This is why some patients find that sitting, leaning on a shopping cart or bending forward reduces their leg symptoms.
How Spinal Stenosis Is Diagnosed
Diagnosis combines the patient's symptoms and neurological examination with imaging that shows where spinal narrowing is occurring.
Your provider will review where symptoms occur, what triggers them and how walking, sitting or spinal position affects the pain.
Strength, sensation, reflexes, balance and walking ability may be assessed for signs of nerve compression.
These studies can show bone spurs, arthritis, alignment abnormalities and narrowing caused by bony structures.
MRI provides detailed views of the spinal canal, discs, ligaments and nerves and can help identify areas of compression.
Treating Spinal Stenosis
Treatment depends on the location and severity of the narrowing, the degree of nerve involvement and how much symptoms interfere with normal activity.
Physical Therapy
Therapy may focus on improving strength, flexibility, posture and movement patterns while maintaining as much function as possible.
Medication
Anti-inflammatory, pain or nerve-related medications may be considered based on the patient's symptoms and overall condition.
Epidural Injections
Epidural steroid injections may be considered for selected patients to reduce inflammation around irritated spinal nerves and provide temporary symptom relief.
Surgical Evaluation
Decompression surgery may be considered when severe spinal narrowing causes progressive neurological symptoms, significant weakness or disabling pain despite appropriate conservative care.
Progressive Weakness or Loss of Function Requires Prompt Evaluation.
Seek prompt medical attention if spinal stenosis symptoms are accompanied by rapidly worsening weakness, significant difficulty walking, new loss of bladder or bowel control, numbness in the groin or saddle region, or sudden severe neurological changes. These symptoms can indicate serious compression of the spinal cord or nerve roots.
Is Back or Neck Pain Limiting How Far You Can Walk?
Schedule a consultation to determine whether spinal stenosis may be contributing to your symptoms and discuss treatment options designed to improve comfort and function.