Spinal Stenosis Animation
Symptoms, Causes, Diagnosis, and Treatments
In this animation, you’ll learn the basics of spinal stenosis. The term stenosis means abnormal narrowing. Spinal stenosis occurs when one (or more) of the natural nerve passageways between the vertebral bodies—the neuroforamen—become narrow. This is called foraminal spinal stenosis.
Another type of spinal stenosis is central canal stenosis. This refers to a narrowing of the spinal canal; the hollow center of the spine that holds and protects the spinal cord.
Figure1 illustrates the bony components of the fourth cervical vertebra in the neck. You can see the neuroforamen (where the nerve roots exit), as well as the spinal canal (where the spinal cord is).
Figure 2 depicts the nerve structures, including the spinal cord in relation to some of the bony elements.
What Causes Spinal Stenosis?
Spinal stenosis is sometimes called the gray hair of spinal disorders because it is more common in older adults.
Growing older, body wear and tear, and degenerative changes to the spine affect its structure. Intervertebral discs can become less pliable and less able to cushion your movements; they may also herniate and bulge out. You may develop bone spurs (osteophytes) on your spinal joints that make it difficult to move without pain. Even a past neck or back injury can take a toll on the spine.
As parts of the spine change or are injured, they can narrow the spinal canal and/or the neuroforamen. This can compress and irritate the nerves and/or spinal cord—leading to back pain or neck pain (as well as other symptoms).
Spinal Stenosis Symptoms
Spinal stenosis can affect any level in the spine, but is more common in the cervical spine (neck) and lumbar spine (low back).
Listed below are typical symptoms of spinal stenosis.
- mild to severe
- periodic to constant
- aggravated by standing, sitting, or walking
- Deep achiness
- Sensations of tingling, numbness
- Muscle spasms, cramping
- Arm or leg weakness
- Symptoms that require prompt medical attention include:
- bowel or bladder dysfunction (eg, inability to urinate)
- difficulty walking
- problems with balance
Additionally, sometimes pain and symptoms radiate (spread) into the arms or legs. This is called radiculopathy (although you may have also heard the term sciatica for pain that shoots down the leg).
How Does My Doctor Diagnose Spinal Stenosis?
To diagnose spinal stenosis, your doctor will perform an in-depth review of your medical history, as well as a physical and neurological examination.
During the evaluation, you may be asked to walk normally and then on tip-toe. Your range of motion is assessed when you bend forward and backward, and then side-to-side at the waist. Throughout your consultation, the doctor asks questions.
Questions your doctor may ask include:
- When did pain and symptoms begin?
- Was the onset associated with a specific activity, such as gardening?
- How long have you had these symptoms?
- Have your symptoms gotten worse?
- Please rate your pain on a scale from 1 to 10, with 10 being the worse pain imaginable.
- How does pain affect your everyday activities?
- Do close family members have any types of neck or back problems, such as your mother or father?
Special imaging tests may be ordered by your doctor, such as x-rays, CT scans or MRIs. These can help him/her more accurately diagnose the extent of your spinal stenosis.
Treatments for Spinal Stenosis
As a reassurance, spine surgery is usually the last resort to treat spinal stenosis.
Non-surgical treatments may include:
- Non-steroidal anti-inflammatory medication (NSAIDs)
- a drug to relax muscle spasms or muscle cramping
- pain medication
- epidural steroid injections
- physical therapy
- passive PT may include massage, ultrasound, moist heat
- active PT may involve gentle movements and exercise as tolerated
Any of the treatments listed above may be combined ; this is called multidisciplinary treatment.
If non-surgical treatments don’t help ease your pain—or if your pain progressively worsens or neurological symptoms develop or increase—your doctor may recommend surgery. Depending on your doctor’s specialty, he may refer you to a spine surgeon—such as an orthopaedic spine surgeon or neurosurgeon.
Spinal stenosis may cause back pain or neck pain, but there are ways to treat and manage it so that you can keep up with your daily life. Talk to your doctor about the best treatments for your pain.