Spinal stenosis is a disorder in which the spaces of the spine narrow, resulting in putting pressure on the spinal cord and/or nerve roots. This narrowing can take place in one or more of these three areas of the spine:
- The canal in the centre of the vertebral or spinal column, through which the spinal cord and nerves run
- The canals at the base or roots of nerves where they branch out from the spinal cord
- The spaces between the vertebrae where the nerves leave the spine and branch out towards other parts of the body
Causes of Spinal Stenosis
Spinal stenosis can be either inherited or acquired. Some people may have inherited a small spinal canal or it may be because of scoliosis, or the curvature of the spine, which is also thought to be inherited. There is also an inherited disorder called achondroplasia, which can cause the diameter of the spinal canal to be reduced.
There are several ways spinal stenosis can be acquired. It is most often seen as the result of age, due to a gradual, degenerative process. As we age, the ligaments of the spine can thicken and calcify, while bones and joints may also enlarge with age.
Spinal stenosis could also appear as a reaction to a problem in another part of the spine, such as a slipped disc. There are also two forms of arthritis that are common causes of spinal stenosis; osteoarthritis, which affects the joints of the body, including the spine, and rheumatoid arthritis, which affects the soft tissue of the joints.
Symptoms of Spinal Stenosis
In some cases, the spinal column can narrow without producing symptoms, but there is usually a slow progression of symptoms. While the back or neck may not hurt, many people experience numbness, cramping, weakness or general pain in the legs or arms.
If the affected area is putting pressure on a nerve root, pain may be felt radiating down a leg, such as with sciatica. Stretching or sitting may sometimes relieve the pain, as this forces the spine to open up. With more severe cases, there may be problems with bladder or bowel function.
Diagnosis of Spinal Stenosis
A diagnosis is usually made by your doctor using a combination of your medical history and a physical examination, including your reflexes, sensation and muscle strength in your arms and legs, whether you experience pain or symptoms when you bend backwards, or your limitation of movement. Your doctor may also order a CT scan or MRI, both of which are effective of showing the spinal column, spinal cord and other soft tissues in the affected area.
Treatment of Spinal Stenosis
Treatment will depend on the severity of the progression of the disorder. For less severe cases, your doctor could prescribe anti-inflammatory medicine, light pain medication, such as Paracetamol, injections such as corticosteroid to reduce inflammation and pain or nerve blocks, which are anesthetic injections which can temporarily relieve the pain at a nerve root, physical therapy or a lumbar brace to help support the back. Surgery could be considered for those that have lost the ability to walk due to numbness or weakness or bladder or bowel function.