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What is spinal stenosis?

Dr. Georgiy Brusovanik
Orthopedic Surgeon

When spinal stenosis affects the neck, patients will often complain of difficulty when handling of small objects, such as buttons or coins. Some will frequently drop objects or notice a change in hand writing.

When patients have spinal stenosis of their lower back, symptoms usually include pain, numbness or cramping in their legs. Sometimes patients will notice that they have an easier time walking when they lean on a "shopping cart". Some will even find it easier to walk upstairs than downstairs.
 
It's always a good idea to see a spine surgeon if such symptoms persist. However, when patients experience loss of bowel or bladder function, numbness in the groin, or loss of stability when trying to walk, I recommend seeing a doctor without any delay.

Spinal stenosis is a narrowing in the spine, usually found in the neck or lower back. This generally occurs in people over the age of 50, but may occur in younger people suffering from a spinal injury. A person suffering from stenosis may experience sensory or motor changes in both arms and/or both legs. Symptoms include burning, pain, numbness, tingling, weakness, or total loss of movement or feeling. These sensations may last only 10 minutes or up to 36 hours. A magnetic resonance image (MRI) is typically used to determine if a person has stenosis; a computerized tomography (CT) scan may also be used.

(This answer provided for NATA by the University of Tampa Athletic Training Education Program)

Spinal stenosis is a narrowing of the spinal canal where the spinal cord passes through. It is common in the neck or cervical spine where it can press on the spinal cord and cause numbness and weakness in the arms and leg as well as urinary retention. It is also common in the low back or lumbar spine where it is more likely to also squeeze nerve roots and not the spinal cord itself since the cord ends at the L1 (i.e. 1st lumbar vertebra). The stenosis is caused by degenerative changes in the spine.
Dr. Stephen Parker, MD
Physical Medicine & Rehabilitation Specialist

Spinal stenosis is essentially a narrowing of the areas of the lumbar, thoracic, or cervical areas of the spine. The lumbar area involves the low back, the thoracic area involves the mid back and the cervical area involves the neck area.

Osteoarthritis is brought on by wear and tear and tear over the years, thereby causing narrowing in the area of the spinal column where the spinal nerves exit. When this occurs there is a decrease in transmission of impulses responsible for both movement and sensation in the areas innervated or supplied by the nerves in the neck, shoulders, midback, and low back areas. This can contribute to numbness, cramping, pain from the neck down, the neck, shoulders, arms, chest, buttocks, thighs, and calves from a sensation standpoint. It can also contribute to weakness in those portions of the leg or arm that are innervated by the nerves affected during the stenosis. Symptoms are likely to be present or they can become worse with standing, sitting, or walking a condition called claudication. In the setting of lumbar spinal stenosis a straight leg raised position can produce pain which can be synonymous with lumbar spinal stenosis. More serious symptoms can include difficulty with balance, problems controlling the bowel or bladder, and in some cases it can represent a medical emergency. This difficulty or the severity of the spinal stenosis contributing to these particular problems can be determined to be myelopathic (involving the spinal cord) possibly representing a need for immediate surgical intervention. Most spinal stenosis can be treated conservatively depending on the patient's symptoms. The most effective medications for this problem are nerve stabilizing medications like Dilantin or Lyrica. Certainly surgery could be performed in the form of a foraminotomy which is an opening of the foramen where the spinal nerves pass through.

Laminectomy is another procedure which involves the removal of a small area of the bone in the vertebrae which is taken away to allow room for the disk and/or origins of a spinal nerve.  When these procedures are done sometimes spinal fusions have to be also performed to stabilize the spine. Spinal stenosis can be caused by arthritis, herniated or slipped disk. Paget's disease, which is a disease of the bone, tumors of the spine, birth defects, and also traumas can also contribute.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.