Information From Your Health Care Provider

SPINAL STENOSIS

Basic information

description

Spinal stenosis occurs when the space around the spinal cord narrows. This puts pressure on the spinal cord and the spinal nerve roots. The narrowing can occur in the space at the center of the spine, the canals where nerves branch out from the spine, or the space between vertebrae (the bones of the spine). It usually affects the upper spine (cervical spinal stenosis) or lower spine (lumbar spinal stenosis). The disorder occurs mostly in people older than 50.

FREQUENT SIGNS & SYMPTOMS

May not cause symptoms or they may start gradually and worsen over time. Symptoms may come and go. Symptoms are usually worse with standing or walking.
Back pain. It lessens with leaning forward or sitting.
Numbness, weakness, cramping, or pain in the arms or legs.
Burning pain in buttocks or legs (sciatica).
Pain in the neck or shoulders.
Foot drop (problem with lifting front part of foot).
Loss of balance.
Loss of bowel or bladder function (cauda equina syndrome). In severe cases, nerves to your bladder or bowel may be affected.

causes

Spinal stenosis is either acquired or primary. Acquired spinal stenosis is the most common type and is usually a result of arthritic changes in the spine that occur with aging. Primary spinal stenosis is less common and is present at birth.

risk increases with

Age over 50.
Osteoarthritis.
Rheumatoid arthritis.
Other risks include excess fluoride in the body, herniated disk, ligament changes, spinal tumors, injury, Paget's disease (a bone disease), or inherited disorders.

PREVENTIVE MEASURES

None specific. To reduce risk, exercise regularly and maintain a healthy weight.

expected outcomes

Conservative treatment helps improve symptoms in many cases. Others can be helped with surgery.

possible complications

Loss of feeling in the arms, hands, feet, or legs. May not feel the effects of an injury or infection.
Limited activities of daily living or disability.
Loss of bladder or bowel control.
Surgery complications.
Symptoms recur a few years after surgical treatment.

diagnosis & treatment

general measures

Your health care provider will do a physical exam and ask questions about your symptoms and activities. Medical tests may include x-ray, CT, MRI, bone scan, nerve study, or myelogram (a special x-ray).
Treatment depends on the severity of the symptoms. Nonsurgical options are drug therapy, physical therapy, lifestyle changes, or use of a back support device.
Lifestyle changes can include extra rest, limits on activities, and home exercises.
A neck brace, back brace, or corset device may be recommended for supporting the back.
Surgery is an option if other treatments do not help or if symptoms are severe. There are different surgical procedures and the choices will be explained. Surgery can relieve the pressure, lessen pain, and improve function. It does not stop the degenerative process.
Alternative therapies (e.g., massage, chiropractor therapy, acupuncture, or acupressure) may be of help.

medications

Your health care provider may prescribe:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain.
- Drugs for pain (nonprescription or prescription).
- Epidural injections to relieve pain and inflammation.

activity

Rest or limited activity may be recommended. Avoid activities that worsen symptoms (e.g., excess standing).
Leaning forward helps reduce pain symptoms. Using a walking stick or walker can help with walking.
Physical therapy can help to maintain strength and flexibility. Biking or pool exercises are other options.