Spinal stenosis

What is spinal stenosis?

Spinal stenosis, (also called spinal canal stenosis or lumbar spinal stenosis), is a narrowing of the canal in which the spinal cord sits. The narrowing can put pressure on the nerves in the back, which can cause pain and weakness in the arms or legs.

Surgery for spinal stenosis involves widening the canal to relieve the pressure on nerves.

What are the symptoms of spinal stenosis?

Many people don’t experience any symptoms, even if the spinal stenosis shows up on a scan.

When symptoms start, they usually get worse over time. The symptoms depend on which nerves are affected. They include:

• numbness, weakness or tingling in a hand, arm, foot or leg
• problems with walking and balance
• neck pain or back pain, especially when standing upright
• pain going up and down the leg
• problems with the bowel or bladder
• difficulty having sex

What causes spinal stenosis?

Spinal stenosis is usually caused by arthritis, most often after the age of 50. Some people are born with a narrowed spinal canal, which puts them at greater risk. Spinal stenosis can happen after a disc prolapse (a ‘slipped disc’, or a problem with the spongy discs between the bones of the spine).

Spinal stenosis can also be caused when a thickened ligament bulges into the spinal cord, by a tumour, or by an injury to the back.

The most common form of spinal stenosis is in the lower back (called a lumbar stenosis). It can also happen at the top of the spine (called a cervical stenosis).

How is spinal stenosis treated?

Spinal stenosis is usually diagnosed using an x-ray, MRI or CT scan.

Your doctor may recommend medicines to reduced pain, inflammation and swelling, and physiotherapy to build up your strength, flexibility and balance. Losing weight if necessary can help, as can exercise to strengthen muscles and improve endurance. Some people use devices such as a corset or a brace, or are recommended injections of steroids into the back to reduce pain and inflammation.

If you are very disabled by the symptoms or other treatments don’t work, surgery called a laminectomy may be an option. This operation removes part of the vertebra (spinal bone), along with some ligaments, to create space and take the pressure off the nerves. Sometimes it also involves a fusion (joining 2 bones together).

Most people are advised to try other treatments first before resorting to surgery.

What you can do

You may be able to control the pain with over-the-counter pain medicines or with hot or cold packs.

If your balance is affected, using a cane or walker will make you more stable and will help reduce the pain because you are leaning forward.