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What is spinal stenosis? It’s a condition in which the spinal canal narrows due to:
- A herniated disc that encroaches on the spinal canal from the front
- Thickened ligaments that encroach on the canal from both sides.
A narrowed spinal canal impedes the blood supply to the nerves, causing pain. Bending forward increases the size of the canal; hence, it relieves the symptoms. Standing or extending the back decreases the size of the spinal canal, which aggravates the symptoms of spinal stenosis.
A small number of people are born with shortened spinal structures called pedicles, which can lead to symptoms of spinal stenosis at a relatively young age. Spinal stenosis occurs most often in the lower back (75 percent of the time) and neck.
Among those in the higher risk category for spinal stenosis are women, men and women 50 and older, and people who’ve had a previous injury or surgery of the spine.
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What Is Spinal Stenosis? The Wear-and-Tear Factor
The most common cause of the narrowing process is “wear and tear” osteoarthritis, according to the American College of Rheumatology (ACR). Other causes are aging, heredity, tumors, trauma, and repeated back surgery. The result is pain in the lower back and legs that can be aggravated by walking and standing. The size of the spinal canal decreases significantly when we assume the erect position (standing and walking), but returns to the normal size when we sit or bend forward.
Spinal stenosis is characterized by low back pain, numbness, or tingling. Also, hot or cold sensation, weakness, or leg fatigue might occur with prolonged standing or walking. Some people feel more clumsy than usual or have falls. Because other conditions also cause these symptoms, it’s important to see your doctor for a full evaluation.
Among the tests used to confirm a diagnosis of spinal stenosis are the following:
- An x-rays of the spine to check for osteoporosis, bone spurs, and narrowing of the spinal canal
- A computed tomography (CT) scan
- A magnetic resonance imaging (MRI) to take pictures of the spinal cord and nerves
- An EMG (electromyogram) to assess nerves going to the legs
- An x-ray of the hips or knees
Spinal Stenosis Treatment
WHAT IS SPINAL STENOSIS, AND HOW CAN I GET RELIEF?
If you’re dealing with spinal stenosis, what can you do to feel better? The American College of Rheumatology (ACR) offers the following suggestions as ways to ease pain caused by spinal stenosis.
- Move more. Exercise at least three times a week for at least 30 minutes.
- Modify your activity. Avoid movements than can trigger or worsen the pain—lifting heavy objects, for example, or walking long distances.
- Talk to your doctor about pain medications and complementary therapies such as acupuncture or massage.
- Explore non-surgical options first except in rare cases when pain, weakness, and numbness develop rapidly.
You can temporarily relieve the symptoms of spinal stenosis by leaning forward slightly while you’re walking or lying down with your knees drawn to your chest. For more long-term symptom relief, try anti-inflammatory medicines, such as aspirin and ibuprofen, and rest.
Epidural steroid injections may be recommended in some cases, but they do not provide long-term relief in moderate-to-severe cases of spinal stenosis. A 2014 study suggests no particular benefit from steroid injections for treating stenosis.
Minimally invasive spine surgery has become an effective procedure to treat spinal conditions, including spinal stenosis, herniated disc, and sciatica. It involves smaller incisions, less loss of blood, and faster recovery. Some patients may be candidates for decompression laminectomy, in which bone spurs and buildup of bone in the spinal canal are removed. The procedure opens up space for the spinal cord and nerves.
What Is Spinal Stenosis Surgery Success Rate?
The success rate of a laminectomy is 80 percent, according to the University of Maryland Baltimore Washington Medical Center. Spinal fusion is often performed after a laminectomy to connect two or more vertebrae and provide better support for the spine.
After most lower back procedures, doctors will encourage you to gradually resume physical activities. If you’re overweight, losing the extra weight will reduce the load on your spine and help relieve your pain. You should be able to walk farther and stand for longer periods of time once your symptoms have improved.
Ooriginally published in 2017, this post is regularly updated.