Spinal Stenosis

Introduction

Spinal stenosis is a narrowing of one or more areas in your spine, most often in your upper or lower back. This narrowing can put pressure on spinal nerves or directly on the spinal cord.  Spinal stenosis can cause cramping, pain or numbness in your legs, back, neck, shoulders or arms, a loss of sensation in your extremities, and problems with bladder or bowel function.  Mild symptoms of spinal stenosis are often helped by conservative (non-surgical) treatments.  In severe cases of spinal stenosis, surgery may be necessary to create additional space for the spinal cord or nerves.  Although this usually provides some relief, it can not repair damaged nerves or stop the degenerative processes that often lead to spinal stenosis. Unfortunately, even after surgery, symptoms of spinal stenosis may recur or worsen over time.

Causes

  • Degenerative joint disease of the spine (osteoarthritis)
  • Lumbar or cervical intervertebral disc herniation
  • Spondylolithesis
  • Trauma

Symptoms

  • Pain or cramping in your legs when standing or walking
  • Back pain that radiates though the buttock and hip down to the leg (lumbar stenosis)
  • Neck pain that radiates through the shoulder and down the arm (cervical stenosis)
  • Numbness, tingling, or weakness in your leg or foot (lumbar) or arm and hand (cervical)
  • Loss of balance (cervical stenosis)
  • Loss of bowel or bladder function (either cervical or lumbar)

Treatments

Many people with spinal stenosis can be effectively treated with conservative measures.  Surgery may be indicated if you have severe disabling pain and an inability to walk.  Acute loss of bowel or bladder function is usually considered a medical emergency and requires immediate surgical intervention.  Conservative treatments include:

  • Physical therapy, chiropractic manipulation, stretching programs
  • Ice or heat
  • Anti-inflammatory drugs (ibuprofen, naproxen, etc.)
  • Prescription pain medications
  • Lumbar or cervical epidural steroid injections
  • TENS