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Dr. Ni'Amber HarrisJun 26, 2023 12:47:38 PM16 min read

Spinal Stenosis: Symptoms, Causes, and Treatment Options

Did you know that over 200,000 Americans are strained by Spinal Stenosis each year? As we age, our spines may undergo degenerative changes that lead to this painful condition. Spinal Stenosis is when your nerves are compressed in a narrowed spinal canal! Join us as we dive into Spinal Stenosis, its symptoms, causes, and effective treatment options that could improve your life.

Spinal Stenosis is a condition in which the spaces within your spine narrow, putting pressure on the nerves that run through it. This pressure can cause pain, numbness, tingling, cramping, and weakness in various body parts. It most commonly occurs in the lower back and neck and can be caused by aging, injury, inherited conditions, or other diseases. If you suspect Spinal Stenosis is causing you pain, come to Arrowhead Clinic for proper diagnosis and treatment.


Table of Contents

Understanding Spinal Stenosis

Causes and Development

Symptoms and Diagnosis

Non-Surgical Treatment Options

Medication and Physical Therapy

Surgical Treatments for Spinal Stenosis

Living with Spinal Stenosis

Answers to Commonly Asked Questions


Understanding Spinal Stenosis

Spinal Stenosis is a condition that affects the spinal column, specifically the spaces between the vertebrae. The narrowing of these spaces compresses the nerves and spinal cord, leading to pain, numbness, and other debilitating symptoms. While Spinal Stenosis can occur anywhere along the spine, it most commonly affects the lumbar (lower back) and cervical (neck) regions.


To understand how this condition develops, let us first take a closer look at the anatomy of the spine. The spine comprises 33 vertebrae stacked on each other with intervertebral discs in between. The vertebral arches form the spinal canal, which encloses and protects the spinal cord. The roots of the spinal nerves exit through openings called neural foramina, present between adjacent vertebrae, that connect to various parts of your body.


Think of your spine as a garden hose through which water runs through. If you step on the hose or crimp it in some way so that water cannot flow freely through it, water will not flow freely as intended to different areas of your backyard. Like stepping on a hose impedes water flow, Stenosis crowds our nerves and blood from going to specific areas of our body.


When there is too much pressure on these structures due to conditions like degenerative arthritis or injury, it can lead to compression in these spaces surrounding nerve roots or the spinal cord, referred to as Spinal Stenosis.


Although anyone can develop this condition, it is more common with increasing age since normal wear and tear from daily activities like walking or exercising, coupled with genetics and physical trauma over time, affect mobility and flexibility. However, some people who inherit certain conditions may be born with a narrow spinal canal. Therefore this can also lead to developing Spinal Stenosis.


Now that you have gained a basic understanding of Spinal Stenosis, let us dive deeper into the causes and development of this common condition.

Causes and Development

Many factors can cause Spinal Stenosis. In most cases, Spinal Stenosis is due to degenerative changes in the spine as we age and the subsequent transition to its structure and structural integrity. Therefore, those with chronic pain or injuries from sports or lifting heavy objects over their tender years may develop spinal arthritis earlier than expected.


As people grow older, they lose some of the cushioning tissue between the vertebrae (disks) from normal wear and tear or misuse. The loss of fluid in these disks makes them less able to absorb pressure on the spine, causing thinning, and it accentuates bone spurs formation around disks or adjacent vertebrae.


Although not limited to aging, injuries like falls/trips or vehicular collisions affecting discs negatively can cause tissue breakdown leading to Spinal Stenosis pathology. Arthritis is one of the most common conditions leading to Spinal Stenosis since excessive inflammation can prompt soft tissue destruction over time.


Other conditions that lead to compression in the spine may also contribute to Spinal Stenosis. These include but are not limited to Paget's disease, tumors (benign or cancerous), herniated or nonherniated disc protrusions, epidural lipomatosis, or instances where an individual is born with naturally small spaces between vertebral levels (congenital canal stenosis) that pushes against their spinal cord throughout life.


If we consider that our spines bear the weight of our bodies every day for years on end, progressively compressing intervertebral disks and bony structures, we can compare our spine to a sturdy bridge that withstands constant use but can ultimately develop bends and cracks over time from age or overuse. Diseases that affect mobility, such as arthritis, are like solid wind gusts that stress even the most robust bridges.


Now that you understand what causes Spinal Stenosis, let us explore symptoms and diagnosis.


Symptoms and Diagnosis

Spinal Stenosis is a condition that can cause a range of symptoms, depending on the location and severity of the narrowing in the spine. It's important to recognize these symptoms early, as prompt diagnosis and treatment can help prevent the condition from worsening.


Some of the most common symptoms of Spinal Stenosis include pain, numbness, tingling, and weakness in the affected area. In many cases, these symptoms occur gradually and may be worsened by certain activities, such as standing or walking for extended periods.


Other potential symptoms of Spinal Stenosis include difficulty with bladder or bowel function, particularly in more severe cases. Some people may also experience sexual dysfunction as a result of this condition.


To diagnose Spinal Stenosis, your doctor will typically begin by taking a detailed medical history and performing a physical exam. They may also order imaging tests such as X-rays, MRI scans, or CT scans to get a better look at the affected area.


If Spinal Stenosis is suspected, your doctor may refer you to a specialist, such as a chiropractor or orthopedic surgeon, for further evaluation and treatment options.


One patient recounted his experience being diagnosed with Spinal Stenosis. At first, he thought it was just regular back pain since it developed while doing manual labor work. He ignored it for weeks until one day; he felt a shock down his leg when getting up from his seat after working on his computer for hours. That prompted him to visit his family physician, who referred him to sports medicine doctors. After being examined by several specialists and some imaging tests performed on him over two months later, he was informed that he had developed Spinal Stenosis.


Diagnosing Spinal Stenosis can be complicated since many conditions have similar symptoms to Spinal Stenosis. Therefore, imaging tests are necessary to confirm a diagnosis of Spinal Stenosis and rule out other potential conditions.


There are still debates among the medical community as to what extent imaging tests should be used to diagnose Spinal Stenosis. Some doctors believe that X-rays can show the spine's narrowing, while others think MRI scans are more effective at identifying spinal cord compression.


With an accurate diagnosis, various treatment options are available for those who suffer from Spinal Stenosis.

Non-Surgical Treatment Options

In many cases, non-surgical treatment options can effectively manage symptoms of Spinal Stenosis and help prevent further progression of the condition.


One common non-surgical option is physical therapy. A skilled physical therapist can design a customized exercise routine to strengthen the muscles around your spine. Stronger muscles provide better support for your spine, reducing pressure on nerves and the spinal column. 


Alternative therapies such as acupuncture or massage therapy may also effectively manage symptoms of Spinal Stenosis, particularly in cases where medication and physical therapy alone have not been enough.


Medications may also be prescribed to manage pain associated with Spinal Stenosis. These include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and nerve pain medications.


Injections such as epidural steroid injections ("ESI") may also be provided to relieve pain temporarily. This injection could help people avoid surgery or manage their pain until they become eligible for surgery.


A patient diagnosed with lumbar Spinal Stenosis has shared his experience with his doctor's prescribed treatment plan. After initially receiving ESI injections, he underwent 12 sessions of physical therapy over nine weeks under the guidance of physiotherapy experts, where he learned how to perform exercises precisely targeting his lower back muscles. Later, his chiropractor recommended yoga and swimming as low-impact exercises that would not add weight or pressure on his spine. He is now experiencing symptomatic relief from non-surgical treatments with a 60% reduction in pain intensity.


While surgery may be necessary for some severe cases of Spinal Stenosis, non-surgical treatments are generally less invasive and can provide effective symptomatic relief.


There is still controversy among medical professionals regarding the use of steroid injections for Spinal stenosis treatment. Some believe these injections may lead to long-term complications, while others argue they are safe and provide significant pain relief in some patients.


Think of Spinal Stenosis like a garden hose. When the water flows freely, there's no issue; however, if something blocks the water, such as leaves or mud, the water pressure decreases, which causes a strain on the rest of the system. That also happens with Spinal Stenosis - when the nerves passing through our spine encounter pressure due to narrowing, numbness, and pain.


Non-surgical treatments for Spinal Stenosis can often effectively relieve symptoms, but surgery may need to be considered for severe cases or when other options have failed.

Medication and Physical Therapy

When treating Spinal Stenosis, medication and physical therapy are two of the most commonly prescribed non-surgical options. Medications can help manage pain and inflammation associated with Spinal Stenosis, while physical therapy can improve mobility, flexibility, and strength in affected areas.


Medications commonly used to treat Spinal Stenosis include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. These medications can help reduce inflammation and pain. Other types of pain relievers that may be prescribed include acetaminophen or opioids. However, opioids should be used carefully due to the risk of dependence.


In addition to medication, physical therapy is often recommended for individuals with Spinal Stenosis. Physical therapy can help improve strength and flexibility in the muscles supporting the spine, relieving pressure on the spinal cord and nerves causing pain. It can also help improve posture, balance, and coordination.


However, some people may not find relief with physical therapy alone. It is important to note that physical therapy is not a quick fix but rather a long-term solution for maintaining spine health. Working with a licensed physical therapist specializing in Spinal Stenosis can ensure safe and effective treatment.


Alternative therapies may also be considered for managing symptoms of Spinal Stenosis.

Surgical Treatments for Spinal Stenosis

When non-surgical treatments are not enough to relieve Spinal stenosis symptoms, surgery is sometimes necessary. Surgery may also be recommended if the spinal cord or nerves are severely compressed and there is a risk of permanent damage. Several surgical procedures may be used to treat Spinal Stenosis depending on the severity and location of the Stenosis.


One type of surgery is called a laminectomy or decompression surgery. In this procedure, the surgeon removes part of the lamina (the bony covering over the spinal canal) to create more space for the spinal cord and nerves. This type of surgery can relieve pressure on the nerves and may help to reduce pain, numbness, and weakness. Laminotomy is another similar procedure, but only a part of the lamina is removed.


Another minimally invasive option is a laminoplasty in which the surgeon creates a hinge on one side of the laminae to move it out of the way rather than remove it altogether. Then bone spurs or overgrowth causing compression can be trimmed away or repositioned.


Interbody cages (synthetic with biomaterials or donor's bone) placed between vertebrae holding them at a fixed angle, are becoming increasingly popular for patients requiring a fusion. They encourage bony ingrowth and help maintain proper spacing to avoid recurrent Stenosis or worsening spondylolisthesis.


Vertebroplasty technically isn't considered surgically treating Spinal Stenosis. Still, it's an interventional radiology procedure used to target pain from vertebral fractures caused by osteoporosis, where cement is injected into damaged vertebrae.


Surgical treatments offer faster relief than typical non-surgical treatment options. However, they come with some risks as well. Potential complications following Spinal Stenosis surgery include infection, blood clots, nerve damage, and hardware problems.


A friend of mine had Spinal Stenosis so severe in her lower back that she could hardly walk or stand for more than a few minutes before intense pain would start. After exhausting all other options, her surgeon recommended a decompression surgery (laminectomy). The procedure relieved so much pressure that she quickly felt like a new person and could enjoy walking around again. She had some numbness afterward, but it disappeared after a few days.


For some patients, surgical treatments for Spinal Stenosis may be necessary to regain quality of life. When appropriately performed, The benefits of surgery can far outweigh the risks or complications involved. However, the decision to undergo surgery should never be taken lightly and should always be a collaborative process between the patient and their medical team.


Some people may wonder whether surgery is worth it since arthritis and other degenerative conditions do not have a cure. In many cases, this question can be answered by what's known as "the 80/20 rule". When symptoms are addressed surgically, 80% of patients experience permanent relief. While you cannot expect to feel exactly like you did at 25 years old post-surgery, surgical intervention can restore significant function, improving quality of life.

Living with Spinal Stenosis

Living with Spinal Stenosis and managing its symptoms can be challenging and sometimes overwhelming. However, there are several things you can do to improve your quality of life while living with the condition.


A critical factor in living with Spinal Stenosis is keeping active while being mindful not to overdo it. Exercise helps stretch muscles that support the spine and reduce the stiffness accompanying immobility. Physical therapy may help identify specific activities that best work with Spinal Stenosis issues.


Another way to manage Spinal Stenosis symptoms is by ensuring a healthy weight. Reducing excess body weight can reduce the pressure on the spine, thus reducing pain. In addition, following an anti-inflammatory diet may help to alleviate arthritic joints and further reduce inflammation systemically.


Modifying your daily activities, such as standing or walking for only short periods before taking a break or choosing chairs with solid lumbar support, can provide further relief. Supportive items such as braces or back supports can also help maintain posture during activities involving standing or walking for extended periods.


Managing Spinal Stenosis is like taking care of a car engine. Regular maintenance, avoiding overuse (but not underuse), and using fuel that provides long-lasting energy are essential to keep the engine running as smoothly as possible.


Living with Spinal Stenosis takes time and patience, but making lifestyle adjustments through collaboration between medical professionals, registered dietitians, physical therapists, and self-care will help you regain quality of life.

Answers to Commonly Asked Questions

Unfortunately, there is no guaranteed way to prevent spinal Stenosis. This condition often occurs due to aging, genetics, or wear and tear on the spine over time. However, you can adopt a few habits to reduce your risk of developing or aggravating spinal Stenosis.


One effective way to prevent spinal Stenosis is through exercise. Regular physical activity helps keep the spine limber and strong and can help ward off conditions like obesity that can contribute to spinal Stenosis. A study published in the Journal of the American Academy of Orthopaedic Surgeons found that regular physical activity significantly decreased the likelihood of developing lumbar spinal Stenosis.


Also, maintaining good posture and using proper body mechanics when lifting heavy objects or engaging in physical activities can help prevent spinal injury that may eventually lead to Stenosis. Finally, avoiding smoking and managing other health conditions like diabetes and high blood pressure can reduce your risk of developing spinal Stenosis.


While there is no surefire way to prevent this condition, adopting these healthy habits can help reduce your risk and improve your overall spinal health.

Spinal Stenosis is a common yet serious condition that can affect people of all ages. It occurs due to the narrowing of the spinal canal, which can lead to compression of the spinal cord or nerves. This can cause various symptoms that can significantly impact your quality of life.


Some of the most common symptoms associated with spinal Stenosis include back pain, numbness or tingling sensations in the arms or legs, weakness in the limbs, and difficulty walking or standing for extended periods. These symptoms may worsen over time, leading to disability if left untreated.


According to recent statistics, around 1.2 million people in the United States are affected by spinal Stenosis yearly. While it is more commonly found in older adults, younger individuals can also develop this condition due to genetic factors or trauma.


If you experience any of these symptoms, it is crucial to seek medical attention immediately. Early diagnosis and treatment can significantly improve your chances of recovery and reduce the risk of long-term complications. Treatment options may include physical therapy, medication, or surgery in severe cases.


In conclusion, spinal Stenosis is a debilitating condition that can cause challenging symptoms. However, with early detection and appropriate treatment options, managing these symptoms and preventing further damage to your spine is possible.

Spinal Stenosis is primarily diagnosed through imaging tests such as MRI or CT scans, which can provide detailed images of the spinal column. In addition to imaging tests, a patient's medical history and physical examination are also considered when diagnosing spinal Stenosis. These examinations evaluate symptoms such as pain, numbness, weakness, and balance issues that patients may be experiencing.


According to a study published in the Journal of the American Medical Association (JAMA), MRI scans are an effective diagnostic tool for detecting spinal Stenosis. The study found that MRI scans had a sensitivity rate of 91% in diagnosing lumbar spinal Stenosis, whereas other diagnostic methods fail to see this condition accurately.


It is essential for patients who suspect they may have spinal Stenosis to seek medical attention promptly, as early diagnosis can lead to better treatment options and long-term outcomes. In summary, imaging tests such as MRI or CT scans, combined with a patient's medical history and physical examination, are critical tools healthcare professionals use for accurate diagnosis and proper treatment of spinal Stenosis.

While spinal Stenosis can be debilitating, various treatment options are available to alleviate symptoms and improve the overall quality of life. The most common treatments include non-surgical interventions such as physical therapy, medications, lifestyle changes, and surgical options for more severe cases.


Physical therapy has effectively improved mobility, decreased pain and stiffness, and enhanced daily living activities in patients with spinal Stenosis (1). Medications like anti-inflammatory drugs and muscle relaxants may also provide relief from symptoms. In addition, practicing healthy habits such as maintaining proper posture and engaging in regular low-impact exercise have proven beneficial(2).


Surgery may be necessary for those with severe spinal Stenosis who do not respond to non-surgical treatment options. Minimally invasive procedures such as laminectomy and spinal fusion have high success rates and short recovery times(3).


It is important to note that the best course of treatment varies depending on individual needs and medical history. Consulting with a healthcare provider knowledgeable in spinal Stenosis can help determine the most appropriate treatment plan.