Spinal stenosis occurs when the spaces in your spine narrow. It doesn’t always cause symptoms, but it can result in pain and weakness. Treatments such as medications and exercise can help.
The column of bones known as the spine provides stability and support to your upper body, enabling you to twist and turn.
The spinal cord is made up of spinal nerves, which conduct signals from your brain to the rest of your body. The nerves are usually protected by the surrounding bone and tissues. If the spinal nerves are damaged or impaired, it can affect functions such as walking, balance, and sensation.
Spinal stenosis is a condition in which spaces in the spine narrow, compressing the spinal cord. This process is typically gradual. It can occur anywhere along the spine.
If the narrowing is minimal, no symptoms will occur. But too much narrowing can compress your nerves and cause problems.
There are multiple types of spinal stenosis. They include:
- lumbar spinal stenosis, which affects the lower back
- cervical spinal stenosis, which affects the neck
- foraminal stenosis, which affects the openings in your bones (foramen)
- tandem spinal stenosis, which affects at least two areas of the spine
The symptoms of spinal stenosis typically progress over time as nerves become more compressed.
If you have spinal stenosis, you might experience:
- leg or arm weakness
- numbness in your legs or buttocks
- lower back pain while standing or walking
- balance problems
Sitting in a chair usually helps relieve these symptoms. However, the symptoms may return when you stand or walk.
The most common cause of spinal stenosis is aging. As you age, tissues in your spine may start to thicken and bones may get bigger, compressing the nerves.
Certain health conditions may also contribute to spinal stenosis. They include:
- Achondroplasia: Achondroplasia is a type of dwarfism that interferes with bone formation in the spine as well as other parts of the body.
- Ankylosing spondylitis: Ankylosing spondylitis is a type of arthritis that causes chronic inflammation in the spine. It can lead to the growth of bone spurs.
- Congenital spinal stenosis: Congenital spinal stenosis occurs when you’re born with a spinal canal that’s naturally narrow.
- Ossification of the posterior longitudinal ligament (OPLL): In this condition, calcium deposits form on the ligament that runs through the spinal canal.
- Osteoarthritis: In osteoarthritis, the cartilage that cushions your joints breaks down. The condition can affect the cartilage between vertebrae and may also cause bone spurs to grow in the spine.
- Paget’s disease of the bone: Paget’s disease of the bone is a chronic condition that causes bones to get weaker and grow larger than usual.
- Rheumatoid arthritis: Rheumatoid arthritis involves chronic inflammation, which can cause bone damage and the development of bone spurs.
- Scoliosis: Scoliosis is an abnormal curving of the spine. It may result from certain genetic conditions, neurological abnormalities, or unknown causes.
- Spinal injuries: Slipped (herniated) discs and bone fractures may cause vertebrae or bone fragments to put pressure on the spinal nerves.
- Spinal tumors: These tissue growths may develop in the spinal canal, trigger inflammation, and cause changes in the surrounding bone.
If you have symptoms of spinal stenosis, a doctor will start by taking a medical history, performing a physical exam, and observing your movements.
The doctor may also order tests to check for signs of stenosis. These tests may include:
- X-ray, CT scan, or MRI to view images of your spine
- electromyogram to check the health of your spinal nerves
- bone scan to look for damage or growths in your spine
Treatment for your spinal stenosis will likely start with prescription medication.
Injections of cortisone into your spine can help reduce swelling. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help ease pain.
A doctor may also recommend physical therapy to help strengthen and stretch your muscles.
If you have severe pain or weakness, the doctor may recommend surgery. Most people will be able to manage their condition with nonsurgical treatments.
You may find some relief from your symptoms with one or more home remedies and complementary therapies such as:
- heat therapy, in which you use a heating pad, warm towel, warm bath, or other heat sources to relax stiff muscles
- cold therapy, in which you apply ice or a towel-wrapped cold pack to swollen areas to relieve swelling and pain
Exercise can be a key component of spinal stenosis management. The exercise you perform on your own can complement physical therapy.
Try to build an exercise routine around activities that improve your balance and flexibility or strengthen your spine and core. Speak with a doctor or physical therapist first to ensure your at-home exercise routine is safe and appropriate.
Possible activities include:
- short stints of walking
- using a stationary bike
- certain yoga moves, like Child’s Pose or Cat-Cow
- modified versions of the moves you’ve learned in physical therapy
People with severe pain and weakness may require surgery. A doctor may also prescribe surgery if the condition is affecting your ability to:
- control your bowel or bladder
- perform other routine activities
Several types of surgery are used to treat spinal stenosis.
- Laminectomy: Laminectomy is the most common type of spinal stenosis surgery. A surgeon removes part of the vertebrae to provide more room for the nerves.
- Foraminotomy: Foraminotomy is used to widen the foramen, the parts of the spine where the nerves exit.
- Spinal fusion: Spinal fusion is typically performed in more severe cases, especially when multiple levels of the spine are involved. The surgeon uses bone grafts or metal implants to attach the affected bones of the spine together.
Many people with spinal stenosis lead full and active lives. However, you may need to adjust your exercise routine or other day-to-day activities to help manage your symptoms.
A doctor may prescribe medications, physical therapy, or surgical treatments to relieve pain and other symptoms. You may experience residual pain after treatments, even surgical ones.
Talk with a doctor to learn more about your treatment options and outlook.