Overview: 

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Spinal stenosis is a condition that occurs when bones change shape over time, narrowing the space of the spinal canal, which is where the spinal cord and nerves travel through.

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Your spine is composed of a series of bones, called vertebrae, which make up the spine and the spinal canal.  These vertebrae are stacked upon one another on rubber-like discs.  Running down the length of the spinal canal is your spinal cord, which is composed of a bundle of nerves that provide functionality to the rest of the body.

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Each of the discs in your spine act as shock absorbers between each vertebrae helping to limit damage to the spinal tissues and bones. These discs are made of two parts. The nucleus pulposus is a gelatinous liquid-like center and the annulus fibrosus is a tough elastic band that encircles the soft center.

 

Causes:

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With age, the center of the disc can dry out.  These discs can change shape and bulge into the spinal canal.  The joints and ligaments can also enlarge and bulge into the spinal canal.  This can lead to narrowing of the spinal canal, placing pressure on the spinal cord and nerves.  When this occurs in the lower back, this can result in diffuse leg pain, weakness, and cramping, also known as Neurogenic Claudication.

This most commonly occurs as a result of our body’s natural aging process, also known as degeneration.  When degeneration generates pain, this is known as arthritis.

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Symptoms:

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Spinal Stenosis may or may not produce symptoms.  When it does it can include: 

• Pain in the lower back, buttock, and legs 

• Pain that can increase with physical activity such as walking and/or standing

• Cramping, heaviness, and numbness in the legs

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In addition to symptoms of spinal stenosis, loss of bowel and bladder control, lower extremity sensory deficits, and weakened reflexes can occur when the nerves in the lower end of the lumbar spine become compressed.  This is a condition known as Cauda Equina Syndrome.  If you suspect you have Cauda Equina Syndrome, seek prompt medical treatment. 

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Diagnosing:

 

To diagnose, your doctor will perform a clinical exam and ask you a number of questions regarding your symptoms.  Your doctor may look for abnormalities via a physical examination, X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI). 

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Treatment:

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Non-surgical treatment may be sufficient to control pain and discomfort associated with Spinal Stenosis. The doctor may recommend over-the-counter medications to help reduce pain. Sometimes, relief is found using steroids to help reduce inflammation. If these methods fail, your doctor may recommend physical therapy or Epidural Steroid Injections. 

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During an Epidural Steroid Injection, the doctor uses a live x-ray image to place medicine directly near the area that is inflamed and causing pain.  This is a short outpatient procedure that takes place in a surgical center, doctor's office, or hospital. 

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When non-surgical treatment fails to provide relief, symptoms begin to progressively worsen, or an individual has bowel or leg impairment, surgery may be recommended.