Spinal stenosis occurs when the spaces in your spine narrow, whether from aging, injury, or a medical condition. You may have pain, weakness, or other symptoms if the spinal cord is compressed.
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 surrounding bone and tissues usually protect the nerves. If the spinal nerves are damaged or impaired, it can affect your daily function.
Spinal stenosis is a condition in which the 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 where nerves or vessels pass (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.
- bowel control
- bladder control
- sexual function
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 and 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 naturally narrow spinal canal.
- 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 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: Bone fractures may cause vertebrae or bone fragments to put pressure on the spinal nerves while slipped (herniated) discs can also 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 typically starts 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 and other health conditions that may explain your symptoms. These tests may include:
Treatment for spinal stenosis can depend on the symptoms you are experiencing. Treatment can include:
- nonsteroidal anti-inflammatory drugs (NSAIDs) to help ease pain
- a short course of oral corticosteroids to reduce inflammation
- injections of cortisone into your spine to help reduce swelling
- physical therapy to help strengthen and stretch your muscles
- other medications if you experience nerve pain
The doctor may recommend surgery if you have severe pain or weakness and other treatments have not worked. 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. A physical therapist can typically provide a home exercise program to follow during and after physical therapy.
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 that doesn’t respond to other treatments may require surgery. A doctor may also prescribe surgery if the condition is affecting your ability to:
- control your bowel or bladder
- perform other daily 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.
How serious is spinal stenosis?
Spinal stenosis can vary in severity, depending on if the nerve is compressed and how much of the spine is affected. Spinal stenosis may also get worse over time.
What are the 4 stages of spinal stenosis?
The four stages of degenerative disc disease include:
- Stage 1: Dysfunction stage, in which the spine loses protection from shock, and you may have mild pain
- Stage 2: Dehydration stage, in which you continue to lose function and may experience moderate pain
- Stage 3: Stabilization stage, during which spinal stenosis occurs, and you may feel severe pain
- Stage 4: Collapsing stage, in which the spinal discs may collapse, and you may experience severe pain
What are the severe symptoms of spinal stenosis?
If the spinal cord is compressed due to spinal stenosis, you may experience pain, numbness, or other symptoms. In severe cases, it can lead to a loss of bowel or bladder control and limited mobility.
What is the most common treatment for spinal stenosis?
The most common treatment for spinal stenosis typically involves medication to reduce swelling and physical therapy to strengthen the surrounding muscles. Physical therapy may include mobility and strengthening exercises to help reduce pain and other symptoms.
What is spinal stenosis pain like?
Spinal stenosis pain can feel like pain, stiffness, tingling, or numbness. The pain may feel burning or aching pain that is worse while walking, sitting, or standing. These symptoms can radiate down the leg, arm, or buttocks, depending on which part of the spine is affected.
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.