Spinal Stenosis

Virtually everyone will experience some type of degenerative back pain as part of the aging process. In fact, the American Academy of Orthopaedic Surgeons (AAOS) states that as many as 95 percent of Americans aged 50 or older have degenerative changes in their spines potentially causing spinal injuries.

As spines change with aging, the wear and tear on bones, joints, discs and nerves can cause tremendous pain. One common type of degenerative back injury is spinal stenosis, which causes pain and weakness through pressure on the nerve roots.

Fortunately, treatment options for spinal stenosis are available which alleviate pain and restore mobility and function for many people affected by this degenerative spine condition.

What is Spinal Stenosis

Spinal stenosis is caused by a narrowing of the spine, which then places pressure on the spinal cord and nerves. This pressure causes pain and weakness, often in the lower back and legs.

Spinal stenosis most frequently affects men and women over the age of 60, but it can occur earlier as a result of other causes:

  • Arthritis, including osteoarthritis and rheumatoid arthritis
  • Congenital conditions, including a narrow spine or scoliosis (curved spine)
  • Spinal tumors
  • Injuries
  • Paget disease of bone, which interferes with the body’s ability to replace old bone tissue with new bone tissue

Spinal stenosis may be associated with degenerative spondylolisthesis, in which one vertebra slips over another, and degenerative scoliosis, which causes curvature of the spine.

Symptoms of Spinal Stenosis

Back pain is one symptom of spinal stenosis, but because the narrow spinal column places pressure on nerves, a person with spinal stenosis may experience other symptoms instead of back pain including:

  • Pain, numbness or tingling, or weakness in the buttocks or legs
  • Foot problems, including “foot drop” in which the person feels like one foot is slapping against the floor as he or she walks
  • Sciatica, or burning pain that radiates into one or both legs
  • Pain that is improved by sitting or leaning forward, which may increase the space surrounding the nerves and alleviate pressure

Some people may experience serious symptoms that require immediate treatment. If you experience loss of bladder or bowel control or pain, weakness, or loss of feeling in both legs, you may have cauda equina syndrome, which can lead to permanent damage including incontinence or paralysis without emergency surgery.

Treatment Options

Spinal stenosis may be diagnosed after a doctor takes a patient’s history, performs a physical exam, and orders diagnostic testing, such as an MRI, CAT scan, or myelogram, which involves injecting contrast dye into the spine.

Once a physician has made a diagnosis of spinal stenosis, he or she can develop an appropriate treatment plan.

Generally, the first course of action is a conservative, non-surgical treatment plan. This may include anti-inflammatory medication, pain medication, physical therapy or exercise, activity limitations, bracing or lumbar traction, or epidural steroid injections.

If the condition is serious, causing difficulty in performing daily activities, loss of bladder or bowel function, or progressive neurological problems, or if it does not respond to nonsurgical methods, surgery may be necessary.

The two most common types of surgery for spinal stenosis are laminectomy, or the removal of bone, bone spurs, and ligaments that put pressure on the nerves, and spinal fusion, which increases the stability of the spine.