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Spinal Stenosis
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Spinal stenosis

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Spinal stenosis, a condition that causes narrowing around the spinal cord and nerves.

In spinal stenosis, one or more areas in the spine narrow — especially in the upper or lower back — putting pressure on the spinal cord or on the roots of these branching nerves.

This pressure can lead to a wide range of problems — cramping, pain or numbness in your legs, back, neck, shoulders or arms; a loss of sensation in your extremities; and sometimes problems with bladder or bowel function. Most often, spinal stenosis results from degenerative changes in the spine caused by aging. But tumors, injuries and other diseases can also lead to narrowing in the spinal canal.

Mild symptoms may be helped by conservative treatments such as pain relievers, physical therapy or a supportive brace. In more serious cases, your doctor may recommend surgery to create additional space for the spinal cord or the nerves.

Signs and symptoms

Spinal narrowing doesn't always cause problems. But if the narrowed areas compress the spinal cord or the base of the spinal nerves (nerve roots), you're likely to develop signs and symptoms. These often start gradually and worsen over time. The most common include:

  • Pain or cramping in the legs (neurogenic intermittent claudication, pseudoclaudication, false claudication). Compression of the nerves in the lower spine can lead to a condition called neurogenic intermittent claudication. This causes 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. This flexes the spine, taking some of the pressure off the nerves. If you have neurogenic claudication, you may try to relieve your pain by sitting, by bending forward when you walk or by leaning on an object such as a shopping cart or cane.

  • There are two types of intermittent claudication. Vascular claudication results from narrowing or blockages in the leg arteries whereas neurogenic claudication is caused by pressure on the spinal nerves. Although the conditions cause similar symptoms, they differ in two important ways: Vascular claudication becomes worse when walking uphill and improves with rest. The pain of neurogenic claudication, on the other hand, may worsen when going downhill and is often relieved by a change of position.

  • Radiating back and hip pain (sciatic nerve pain). Compressed nerves in the lumbar spine are often the result of a bulging (herniated disk). This compression frequently leads to pain along the path of the sciatic nerve, which extends down the back of each leg. Sciatic pain usually starts in your hip or buttocks and radiates downward. The pain is worse when you're sitting and generally affects only one side. You also may experience numbness, weakness or tingling in your leg or foot. For some people, sciatic pain is a minor annoyance. For others, it can be debilitating.

  • Pain in the neck and shoulders. This is likely to occur when the nerves in your neck are compressed. The pain may occur only occasionally or it may be chronic. In some cases it may extend into your arm or hand. You also may experience headaches, a loss of sensation or muscle weakness.

  • Loss of balance. Pressure on the cervical spinal cord can affect the nerves that control your balance, resulting in clumsiness or a tendency to fall.

  • Loss of bowel or bladder function (cauda equina syndrome). In severe cases, nerves to the bladder or bowel may be affected, leading to partial or complete urinary or fecal incontinence. If you experience either of these problems, seek medical care right away.

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Disclaimer

This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
In no event will The Integrated Medical Clinic be liable for any decision made or action taken in reliance upon the information provided through this web site.

 

 



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Last Modified : 03/15/08 02:19 AM