Spinal stenosis
Definition
Spinal stenosis is a narrowing of the lumbar (back) or cervical (neck) spinal canal, which causes compression of the nerve roots.
Causes
Spinal stenosis mainly affects middle-aged or elderly people. It may be caused by osteoarthritis or Paget's disease or by an injury that causes pressure on the nerve roots or the spinal cord itself.
Symptoms
- Back pain that spreads to the legs
- Difficulty or imbalance when walking
- Leg pain
- Neck pain
- Numbness in the buttocks, thighs or calves, that is worse with standing, walking, or exercise
- Pain in the buttocks, thighs, or calves that is worse with walking or exercise
- Weakness of the legs
Exams and Tests
Neurological examination confirms leg weakness and decreased sensation in the legs.
- EMG may show neurological changes.
- Spinal MRI or spinal CT scan shows spinal stenosis.
- X-ray of the spine shows degenerative changes and narrowed spinal canal.
Treatment
Generally, conservative management is encouraged. This involves the use of anti-inflammatory medications, other pain relievers, and possibly steroid injections. If the pain is persistent and does not respond to these measures, surgery is considered to relieve the pressure on the nerves.
Surgery is performed on the neck or lower back, depending on the site of the nerve compression.
Outlook (Prognosis)
If the nerve roots can be successfully relieved of pressure, the symptoms will not worsen and may improve.
Possible Complications
Injury can occur to the legs or feet due to lack of sensation. Infections may get worse because pain related to them may not be felt. Changes caused by nerve compression may be permanent, even if the pressure is relieved.
When to Contact a Medical Professional
Call your health care provider if you have symptoms of spinal stenosis.
Reviewed By: Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
