The signs can start gradually and worsen over time, including pain or cramping in your legs, numbness or weakness in your hands or feet, and problems with balance. What might be causing such perplexing symptoms? Spinal stenosis, a common condition in older adults, according to Dr. Praveen Kadimcherla, MD, an orthopedic spine surgeon at Atlantic Spine Center.
Defined as a narrowing of the open spaces within your spine, spinal stenosis happens more often in adults 50 and up, placing pressure on both the spinal cord itself and nerves that travel through the spine to the arms and legs, Dr. Kadimcherla says. Seeing a spine specialist is the wisest move to get a precise diagnosis, but fortunately, many possible treatments can offer relief.
“Symptoms of spinal stenosis can vary in both severity and location,” explains Dr. Kadimcherla, who is fellowship-trained in orthopedic and spine neurosurgery. “If the stenosis is in the neck, or cervical spine, tingling in the hand is the most common sign.”
“If the stenosis is in the lower back, you may feel pain or cramping in your legs when standing for long periods or walking, but this typically eases when you sit down or bend forward,” he adds. “More alarmingly, however, spinal stenosis can trigger problems with bladder or bowel function – a true emergency.”
Causes and risk factors
It’s not usually possible to prevent spinal stenosis, but certain risk factors can cause the condition or make it more likely. According to Dr. Kadimcherla, these include:
Aging: “The passage of time can thicken and harden bands of tissue that support the spine, causing bones and joints to enlarge,” he says. “When bone surfaces bulge out – known as bone spurs – spinal stenosis symptoms can result.”
Heredity: If your parent, sibling, or other close relative has had spinal stenosis, you’re more likely to as well.
Arthritis: “Since this condition wears away cartilage cushioning joints, arthritis can lead to spinal stenosis by reducing space between spinal joints where nerves travel through,” he explains.
Injuries: Spinal vertebrae can be fractured or dislocated by trauma such as car accidents, damaging the spinal canal and leading to stenosis.
Herniated discs: Nerve roots can be painfully pinched by the protruding spinal discs that characterize disc herniation.
Ligament thickening: “When the tough cords holding bones in the spine together stiffen or thicken, they can push into the spinal canal and press on nerves,” Dr. Kadimcherla says.
With so many potential causes – which include less-common ones such as spine tumors or calcium deposits – proper diagnosis of spinal stenosis is imperative,” he advises.
Diagnosis and treatment options
How is a diagnosis of spinal stenosis confirmed? It starts with a thorough physical exam and reporting of all symptoms, including their severity and duration, Dr. Kadimcherla says. Next, imaging tests will likely be ordered such as X-rays and MRI or CT scans, which can offer a look inside the body to reveal hard and soft tissues and the forces surrounding them. “Sometimes doctors also use a myelogram, injecting liquid dye into the spinal column, or a bone scan showing where bone may be forming or decaying,” he adds.
Once your doctor knows spinal stenosis is the culprit, so-called “conservative” measures will first be proposed to offer relief. These non-surgical tactics may include:
- Prescription and over-the-counter pain relievers, which may also reduce inflammation
- Temporary activity limits
- Epidural cortisone injections, which are done at a doctor’s office
- Physical therapy and/or prescribed exercises
Surgery is sometimes needed for spinal stenosis, especially if symptoms get in the way of walking or have otherwise become disabling. But this isn’t the usual result, Dr. Kadimcherla says, and even if it’s needed, surgery can often be done using minimally invasive techniques that boast a quicker recovery.
“One of the most serious potential problems caused by spinal stenosis is called cauda equina syndrome, which can lead to loss of bowel or bladder control and paralysis in the legs,” he says. “This condition requires immediate surgery to ensure those symptoms aren’t permanent.”
“Most people with spinal stenosis can be effectively treated with conservative measures and gain relief without needing surgery,” he adds. “Just be aware of your symptoms and communicate openly with your doctor.”