Spinal stenosis is a narrowing of the spinal canal that puts pressure on the spinal cord and / or on spinal nerves as they leave the spine. Compression of the nerve interferes with communication between the brain and the body, and results in sensory problems or loss of function to an area of the body. Compression can occur in the spinal canal, in the nerve root canals or the intervertebral foramen. It can be localized to one area or widespread through a section of the spine.
Spinal stenosis can be congenital or acquired. Congenital conditions that cause spinal stenosis include scoliosis, a congenitally narrow spinal column or a bone defect called achondroplasia.
Most spinal stenosis is acquired, usually as a result of aging, and it usually appears in individuals over 50 years old. Women are more prone to it than men. Normal degenerative changes that occur with aging are most often to blame, especially if arthritis is also present. Spinal stenosis can also be caused by tumors or injury or as a result of another disease, such as Paget's disease.
The symptoms of spinal stenosis depend on where the narrowing is. Most spinal stenosis affects the lumbar, or lower back, area. You experience pain radiating down your leg that is relieved if you sit or bend forward. In severe cases, you could lose bowel, bladder or sexual function and have difficulty walking.
The second most common area for spinal stenosis to occur is in your neck, or cervical spine. People with cervical stenosis may feel pain radiating down an arm, or aching, numbness or tingling in the arm or leg. They may have difficulty with fine motor skills, such as picking things up with their fingers or writing, problems walking or loss of bladder and bowel control.
Symptoms typically appear gradually and get worn over time.
Conservative methods of treatment are used as long as possible. They do not cure the problem, but most people get relief from their symptoms for quite a while while doing prescribed exercises, including flexion. Most people have good results with physical therapy. Chiropractic, massage and acupuncture often help, too.
Most doctors prescribe muscle relaxers or anti-inflammatory drugs to treat the symptoms of spinal stenosis. If those do not work, epidural cortisone treatments and nerve blocks may be helpful.
Occasionally, many people need surgery to correct spinal stenosis. Outpatient arthroscopic surgery may be sufficient to open up the intervertebral foramen or to relieve pressure from surrounding structures.
Sometimes, however, the entire spinal cord must be decompressed, requiring open surgery. A decompression laminectomy may be necessary to remove enough bone and tissue to relieve the pressure on the spinal column.
Spinal stenosis can be very debilitating. Conservative treatment relieves the symptoms and allows you to function normally for quite a long time. The disease is progressive, however, and often surgery is necessary to correct the narrowing and relieve pressure on the nerve.