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Spinal
Stenosis
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Spinal stenosis refers to a narrowing of the spinal
canal. This could be present at birth but is most
often a condition that develops as a person ages.
It can also be caused by arthritic changes, injury,
or surgery.
When the spinal canal becomes narrowed
the nerves which pass through can be compressed. This
may cause them to become inflamed which can cause
pain in the low back or legs. The onset of symptoms
may be slow or sudden. Walking or standing may aggravate
the pain.
The main cause of narrowing of the spine and spinal
stenosis is the breakdown (degeneration) of tissues
caused by the normal aging process.
In mild to moderate cases of spinal stenosis, symptoms
can be controlled using nonsurgical treatment. Nonsurgical
treatment may include medication to relieve pain,
exercise to maintain strength and flexibility, physical
therapy, or corticosteroid injections.
Surgery may be considered for severe symptoms that
are unbearable or are getting worse or that restrict
normal daily activities. If symptoms are severe, they
usually do not improve.1 In these cases, surgery is
usually successful in relieving leg pain and allowing
a person to resume his or her normal daily activities.
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| Cause |
Spinal stenosis is caused by conditions that are
either:
- Acquired through the normal aging process that
leads to the breakdown (degeneration) of tissues.
These conditions may include:
- Degenerative disc disease of the spine.
- Arthritis of the spine.
- Certain bone diseases.
- Injury to the spine caused by trauma.
- Present at birth (congenital), such as defects
in the formation of the spine.
Degenerative disc disease and arthritis of the spine,
both of which result from normal aging, are the most
common causes of spinal stenosis. Changes in the shape
of the spinal canal that are related to the breakdown
of tissue (degeneration) include disc herniation,
thickening of soft tissues, and degeneration of facet
joints and joint capsules. Any of these conditions
can cause squeezing pressure (compression) on the
spinal cord or its nerve roots and can result in symptoms
of spinal stenosis.
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| Symptoms |
The classic symptom of spinal stenosis is leg pain
when walking and standing that is relieved by sitting.
Leg pain is often present when the spine is extended,
as in a standing position, and is relieved when the
spine is flexed, as in a sitting position.
Symptoms of spinal stenosis may include numbness or
weakness of the legs. The lower back (lumbar spine)
is affected by spinal stenosis more often than any
other area of the spine. Since the nerve roots that
pass through the lumbar spine extend to the legs,
the legs are most affected by spinal stenosis.
The main symptoms of spinal stenosis include:
- Leg pain, usually in both legs (worse when
walking or standing).
- Stiffness in legs and thighs.
- Leg numbness or weakness.
- Low back pain.
- A feeling of tiredness in the legs.
- Cramping pain in the leg that occurs during
exercise (such as walking) and is relieved by
rest (pseudoclaudication).
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Some people with severe
spinal stenosis develop a habit of leaning forward
in a stooped position to relieve symptoms.
Spinal stenosis can occur in the neck (cervical
spine), although this is not as common as stenosis
in the lower back (lumbar spine). Symptoms of spinal
stenosis of the cervical spine include: |
- Restricted range of neck movement, but usually
no neck pain.
- Arm numbness or weakness.
- An irregular manner of walking (irregular
gait).
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| In some cases, the severity of symptoms
may not relate to the degree of the narrowing of
the spinal canal as seen on imaging tests. A person
may have very severe symptoms, but tests show relatively
little narrowing of the spinal canal. Or a person
may have mild symptoms, but tests show a significant
narrowing of the spinal canal. |
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| Treatment |
Therefore, treatment is based not only on imaging
test results, but also on the severity of symptoms
and their impact on a person's normal daily activities
and quality of life.
Spinal stenosis usually starts gradually and develops
over a long period of time. Pain, numbness, and weakness
in the legs gradually get worse. A person may be able
to relieve pain by changing positions. For example,
leaning forward or sitting will relieve pain because
it often reduces pressure on the spinal cord or the
nerve roots. For mild to moderate cases, nonsurgical
treatment (such as medications and exercise) can help
relieve symptoms and allow a person to do normal daily
activities.
Doctors agree that the course of spinal stenosis varies-it
may stay the same, get better, or get worse. However,
if symptoms become severe, they usually do not improve.1
Severe symptoms may restrict a person's normal daily
activities and affect his or her quality of life.
If symptoms are still severe after 3 or more months
of nonsurgical treatment, surgery may be considered.
However, surgery may not be an option for some older
adults who have other serious health problems that
make surgery too risky.
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| What Increases Your Risk |
The risk of spinal stenosis increases if a person:
- Is over 60 years old.
- Has an injury to the spine or has other diseases
that affect the spine, such as:
- Spondylosis (inflammation of the joints in the
spine).
- Spondylolisthesis (a shift of one vertebra over
another, due to a defect in the joint that binds
them together).
- Achondroplastic dwarfism (a genetic disorder
in which the bones of the arms and legs do not grow
to normal size and the vertebrae of the spine do
not grow normally).
- Osteoarthritis (a disease of joint cartilage).
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TAIWAN SPINE CENTER
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