Spinal Stenosis Symptoms, Causes & Treatment

Roughly 65 million Americans report some form of back pain annually. Up to 16 million Americans struggle with chronic back pain because it impacts the quality of life and significantly affects day-to-day activities. While our backs are meant to support us for a lifetime, certain factors – from recurring injuries and occupational hazards to genetic disease – can lead to debilitating pain. Thankfully, these conditions are often treatable and sometimes reversible if identified early enough.

Some conditions develop slowly over time, which is why early detection can help improve treatment. One of the more potentially dangerous and often gradual causes of back pain is narrowing the spinal canal, also known as spinal stenosis. This condition currently affects between 250,000 and 500,000 Americans, mostly over the age of 50 – though as our aging population continues to grow, these numbers are expected to rise concurrently.

What Is Spinal Stenosis?

Spinal stenosis is a narrowing of the spinal canal, often age-related, though sometimes caused by other conditions and diseases. The spinal cord runs through the spinal canal, and when compressed, can cause tingling, numbness, and weakness in different areas of the body. The spine is a complex column of bony vertebrae, the spinal canal and its cord running through the center, from the brain and neck down to the tailbone, or the coccyx, and the spinal cord is part of the body’s central nervous system. It relays signals between the brain and peripheral nervous system throughout the rest of the body.

Most spinal stenosis symptoms are caused by compression around the nerve roots that branch off the spinal cord, causing tingling and weakness in the legs (sciatica), arms, and other parts of the body. Spinal stenosis tends to occur most commonly in the lower back and the neck, though it can also occur in the upper back. When severe enough, spinal stenosis can lead to damaged nerves and, if compressed for too long, some degree of paralysis is possible. Some degree of narrowing in the spinal canal may be normal over time, and different treatments – both non-invasive and invasive – can help combat symptoms and improve quality of life.

Imaging technology can be used to identify spinal stenosis, though the narrowing process is often very gradual and would have to be something a specialist would specifically look for. If you are experiencing severe pain in one or more limbs, cannot feel one of your legs or arms, have lost bladder or bowel control, are losing fine motor control in your hands, or have severe balance issues, seek medical care immediately.

Identifying Spinal Stenosis Symptoms

Specific spinal stenosis symptoms are characterized or may hint at potential compression in one or more spine areas. Spinal stenosis can have different symptoms depending on where the spinal canal is narrowing. Signs for the lumbar section (lower back) include:

• • Pain in the lower back.
  • Radiating pain down one leg.
  • Numbness or tingling in the leg.
  • Weakness or a “heavy feeling” in one leg.
  • Pain that worsens when standing for long periods.
  • Relief while sitting, leaning forward, or moving at an incline.
  • Loss of bowel and bladder control in severe cases (seek emergency care).

Symptoms for the cervical section (neck) include:

• • Pain in the upper back.
  • Pain radiating into your arms and hands.
  • The trouble with motor skills such as buttoning a shirt or writing/typing.
  • Lack of feeling and strength in one hand.
  • Loss of bowel and bladder control in severe cases (seek emergency care).

If symptoms suggest spinal stenosis, a specialist will utilize a series of neurological and imaging tests to identify the problem, nature, and scope. Different imaging techniques may be used to identify a narrowing spinal canal.

What Causes Spinal Stenosis?

Narrowing of the spine can occur naturally with age because of osteoarthritis or simple bone degradation because of wear and tear. Cartilage, the tough protective casing that keeps our bones from rubbing against one another, can wear down with age and impact. The body responds to the resulting bone-on-bone friction by creating new bony growths, called bone spurs. These bone spurs can ultimately result in a narrowed spinal canal, as the protective cartilage between our vertebral joints is worn down.

Natural disc degeneration is another age-related cause of spinal stenosis. Every pair of vertebrae is separated by a spongy disc, which may become damaged or worn down over time. When this disc bulges excessively (i.e., becomes herniated), it may press on the surrounding nerve roots. Discs may herniate or rupture because of an injury as well. When the bones in the spine themselves are damaged or fractured, the resulting inflammation can cause swelling that compresses the surrounding nerve roots and spinal cord.

Lastly, but least likely, is a hereditary narrowing of the spinal canal. Some people are born with a narrower spinal canal than necessary to avoid compression. Other spinal issues may contribute to compressed nerves and cause pain or numbness, such as kyphosis or scoliosis.

Treating Spinal Stenosis

Treatment will depend on the severity of the narrowing and its symptoms and their impact on life quality. There are invasive methods for treating spinal stenosis, but these may not always be necessary, at least at first. Physical therapy and a healthy diet plan (to reduce stress on the spine and minimize further narrowing), treating a ruptured or herniated disc (to resolve the compression), and anti-inflammatory drugs (to help reduce swelling) can be ways to address the problem.

In some cases, a minimally invasive intervention, such as a nerve block, can help reduce or eliminate pain for some time. This procedure utilizes a syringe to inject a corticosteroid, painkiller, anesthetic, or other similar drugs into the region around the compressed nerve until the compression stops and the pain dies down. Surgery, when it becomes necessary, will usually involve a laminectomy.

In this case, a doctor will carefully remove portions of the vertebrae to make room for the spinal cord and its nerve roots while maintaining the spine’s stability. If stability is an issue, further procedures may include spinal fusion (utilizing specialized equipment to fuse two or more vertebrae). While spinal stenosis may become more familiar with age, it can vary immensely in severity. If you suspect that your symptoms suggest spinal stenosis, be sure to consult a medical professional.