SPINAL STENOSIS

Spinal stenosis is a narrowing of one or more areas in your spine — most often in your neck or lower back. This narrowing can put pressure on the spinal cord or spinal nerves at the level of compression.

Depending on which nerves are affected, spinal stenosis can cause pain or numbness in your legs, back, neck, shoulders or arms; limb weakness and incoordination; loss of sensation in your extremities; and problems with bladder or bowel function. Pain is not always present, particularly if you have spinal stenosis in your neck.

Spinal stenosis is commonly caused by age-related changes in the spine. In severe cases of spinal stenosis, doctors may recommend surgery to create additional space for the spinal cord or nerves.

When to see a doctor

Call your doctor if you have numbness or weakness in your back, legs, neck or arms.

SYMPTOMS

Many people have evidence of spinal stenosis on X-rays, but have no signs or symptoms. When symptoms do occur, they often start gradually and worsen over time. The most common parts of the spine affected by spinal stenosis are the neck and lower back. Symptoms vary, depending on the location of the stenosis.

SPINAL STENOSIS IN THE NECK

01

Numbness or weakness. Spinal stenosis in your upper (cervical) spine can cause numbness, weakness or tingling in a leg, foot, arm or hand. You may drop things more often or have a tendency to fall.

02

Neck or shoulder pain. This may occur if the nerves in your neck are compressed. However, cervical spinal stenosis often causes no pain. And neck pain can be caused by problems other than spinal stenosis.

03

Loss of bowel or bladder control. In severe cases of cervical spinal stenosis, nerves to the bladder or bowel may be affected, leading to incontinence.

SPINAL STENOSIS IN THE LOWER BACK

Compressed nerves in your lower (lumbar) spine can cause pain or cramping in your legs when you stand for long periods of time or when you walk. The discomfort usually eases when you bend forward or sit down.

CAUSES

Many different types of problems can reduce the amount of space within the spinal canal. The most common of these problems are related to degeneration and the aging process. Other causes range from birth defects to benign or cancerous tumors.

Aging-related causes

Osteoarthritis

With time, the facet joints between adjacent vertebrae in your spine deteriorate. In an attempt to repair the damage, your body may produce bony growths called bone spurs. These bone spurs can narrow the spinal passages.

Disk degeneration

As you age, the cushions between your vertebrae flatten and bulge. Eventually, the tough, fibrous outer covering of the disk may develop tiny tears, causing the jelly-like substance in the disk’s center to protrude and press on your spinal cord and nerve roots.

Thickened ligaments

The tough cords that help hold the bones of your spine together can become stiff and thick over time. The thickening along with bulging into the spinal canal can also narrow the spinal canal and compress nervous tissue.

Other causes

Paget’s disease of the bone

In Paget’s disease, your body generates new bone at a faster than normal rate. This produces soft, weak bones that are prone to fractures. It can also create bones that are deformed or abnormally large. If this occurs in the spine, it can reduce the amount of space available in the spinal canal.

Achondroplasia

This genetic disorder slows the rate at which bone forms during fetal development and in early childhood, resulting in dwarfism. People who have this condition are born with narrow spinal canals.

Spinal tumors

Abnormal growths can form inside the spinal cord, within the membranes that cover the spinal cord or in the space between the spinal cord and vertebrae. Enlarging tumors may compress the spinal cord and nerve roots.

Spinal injuries

Car accidents and other major trauma can cause dislocations or fractures of one or more vertebrae. Displaced bone from a spinal fracture may damage the contents of the spinal canal. Swelling of adjacent tissue immediately following back surgery also can put pressure on the spinal cord or nerves.