Spinal injury can occur to the bones (vertebrae) that make up the spine, or to the spinal cord, which is the bundle of nerves running down the neck and spine that carries electrical signals between the brain and body. Spinal cord injury can disrupt these signals and is therefore extremely serious, because it can result in loss of movement (paralysis) below the point of injury. Damage to the verteb…
What is spinal stenosis?
Spinal stenosis occurs when there is an abnormal narrowing of the spinal column. There are numerous possible causes, but essentially they lead to pressure on the spinal cord and/or the nerves that branch out from it.
What is the spinal column?
The spinal column plays a vital role in the support of the upper body. It allows us to keep an upright posture, bend and twist. It also protects the spinal cord.
Within the spinal column is the spinal canal. Spinal stenosis occurs when there is an abnormal narrowing of this canal. The spine can narrow at one or more of the following parts:
- The space in the center of the spine;
- The canals where the nerves branch out from the spine, or;
- The space between the vertebrae.
Spinal stenosis can occur due to a variety of causes, including the following:
- Arthritis - this is the most common cause;
- Disc herniation;
- Thickening of ligaments;
- Compression fractures - common for people who have osteoporosis;
- Injuries that dislocate the spine, or cause fractures that may cause bone fragments that penetrate the spinal canal;
- Congenital conditions in which the spinal canal is too small from birth;
- Paget's disease (which causes abnormal enlarging and weakening of bone);
- Ankylosing spondylitis;
- Acromegaly, and;
- Tumors of the spine.
The spine is made up of three regions - the cervical, thoracic and lumbosacral spine.
Lumbar stenosis is the most common, with around 75% of cases of stenosis occurring in this region. Lumbar stenosis commonly involves compression of the nerve roots of the lower back, leading to sciatica.
Cervical stenosis is less common, but is potentially more serious, as it can affect the muscles that help with breathing.
Thoracic stenosis is the least common type and can be associated with pain in the ribs.
Signs and symptoms
Some people with spinal stenosis may not experience any symptoms. For others, if the narrowing puts pressure on the nerves or spinal cord, there may be symptoms such as:
- Numbness or weakness in the arms or legs;
- Cramping and pain in the arms or legs;
- Sciatica, or pain that radiates down the back of one leg;
- Foot disorders, and;
- Loss of bladder or bowel control.
Methods for diagnosis
To help diagnose the cause of your symptoms, your doctor will take a detailed medical history, including your symptoms and past injuries, and ask questions about your overall health.
Your doctor will perform a physical examination to assess your strength, sensation and reflexes.
X-rays can be used to show any bone-related causes of spinal stenosis, such as osteoarthritis and bone spurs.
Computerized tomography (CT)
CT scans can provide detailed images of the spinal column to help better diagnose bone-related causes.
Magnetic resonance imaging (MRI)
Bone scans can be useful in detecting fractures, infection or arthritis, but because they cannot differentiate between disorders, they are most commonly used alongside other imaging tests.
Types of treatment
Exercise can be used to build up strength in the muscles of your arms and legs. Exercise can improve your balance, ability to walk, bend, move about and control pain.
Over-the-counter medications, such as acetaminophen and ibuprofen, may provide relief from pain. Some people may be prescribed specific medication to ease muscular spasms.
Corticosteroids may be injected directly into the affected area around the spinal cord to provide temporary, or sometimes permanent, pain relief. These injections are not for regular use and are generally limited to only a few times each year.
When non-surgical treatment has not provided effective relief from symptoms, surgical treatment may be an option for some people. There are different procedures that can be used to alleviate the symptoms, including:
- Decompression laminectomy - to remove the bony spurs in the spinal canal and free up space for the nerves and spinal cord, or;
- Spinal fusion - in which additional bone is used to fuse two vertebrae together, which stops movement at the painful segment.
Severe cases of spinal stenosis may lead to chronic pain, paralysis, or fecal and urinary incontinence, which can be disruptive to normal life.
For most people, there is good relief from symptoms without surgery. However, for others, non-surgical treatment may prove ineffective and surgery will be a good option.
You may be able to lower the likelihood of spinal stenosis by:
- Keeping your back healthy by engaging in regular exercise;
- Maintaining a healthy weight;
- Having good posture, and;
- Not smoking.
- Lumbar Spinal Fusion Surgery.” Spine-Health. Accessed October 3 2014. link here
- Marcia Vital Office of Communications and Public Liaison. “Questions and Answers about Spinal Stenosis.” Accessed October 3 2014.
- link here
- Spinal Stenosis Complications - Diseases and Conditions - Mayo Clinic.” Accessed October 2 2014. link here
- Spinal Stenosis - Symptoms Risk Factors Diagnosis.” Accessed October 2 2014. link here
- Meadows American Association of Neurological Surgeons 5550 Meadowbrook Drive-Rolling. “The American Association of Neurological Surgeons.” Accessed October 3 2014. link here
- Spinal Stenosis | Lumbar Stenosis | Cervical Stenosis.” Accessed October 3 2014. link here
- Spinal Stenosis - Symptoms Risk Factors Diagnosis.” Accessed October 3 2014. link here
FAQ Frequently asked questions
What are the symptoms of spinal stenosis?
The symptoms of spinal stenosis can vary depending on the severity of the narrowing and the area affected, but may include arm or leg pain, numbness and tingling down the arms or legs, bowel or bladder dysfunction, and foot disorders.
What causes spinal stenosis?
The most common cause of spinal stenosis is arthritis. Other causes may include disc herniation, fractures and underlying conditions such as osteoporosis.
Who gets spinal stenosis?
Spinal stenosis can potentially affect anybody, but it is more common in those over 50 years of age.
How is spinal stenosis diagnosed?
Diagnosis of spinal stenosis is based on your doctor taking your medical history, carrying out a detailed physical examination and performing imaging tests.
How is spinal stenosis treated?
Non-surgical treatment of spinal stenosis may involve physiotherapy, changing your daily activities to avoid excessive stress on the spine, and medication or corticosteroid injections. If symptoms fail to respond to non-surgical treatment, then surgery is an …
What can be done at home to treat spinal stenosis?
The symptoms of spinal stenosis can be treated at home using pain-relief medications and following a physiotherapy program to restore flexibility and strength.
Can spinal stenosis be prevented?
You can lower your chances of spinal stenosis by maintaining a healthy weight, following a regular exercise program and practicing good posture.
Is spinal stenosis serious?
Spinal stenosis has the potential to cause chronic pain, paralysis and fecal or urinary incontinence, which can have an impact on a person's quality of life.