Symptoms of Spinal Stenosis

Stewart G. Eidelson, MD
SpineUniverse Founder, Orthopaedic Surgeon
South Palm Orthospine Institute
Delray Beach, FL, USA

What causes Spinal Stenosis?
Some people are born with this narrowing or have a genetic tendency to develop spinal stenosis. For most people though the condition is found in patients over the age of 50. Usually spinal stenosis develops gradually as a result of aging and everyday wear the tear.

As the body ages, microscopic changes occur at the cellular level. The ligaments in the spine may thicken and harden, joints enlarge, and bone spurs (called osteophytes) form. A bulging or herniated disc is common. Most rare is a spinal tumor or spondylolisthesis; this condition develops when one vertebra slips forward onto another.

Any of these conditions can cause spinal stenosis by reducing the size of the space where the spinal cord and/or nerve roots are located. The result is nerve compression and a variety of symptoms.

What symptoms are associated with Spinal Stenosis?
First, the actual narrowing of the spinal canal or neuroforamen does not cause symptoms. Symptoms develop when the spinal cord or nerve roots are compressed; squeezed or trapped. Compression causes inflammation and inflammation can cause pain, weakness, and numbness. Symptoms vary depending on the location of the spinal stenosis. For example, the symptoms of cervical spinal stenosis primarily affect the upper body and lumbar spinal stenosis the lower body.

Cervical Spinal Stenosis
• Pain, burning or tingling sensations, feelings of pins and needles, weakness or numbness in the shoulders, arms, hands.

• Clumsy hand movement.

• Balance disturbance.

• Gait (the way a person walks) may be affected.

Lumbar Spinal Stenosis
• Pain, sciatica, tingling sensations, feelings of pins and needles, weakness or numbness in the buttocks, legs, calves.

• Symptoms may increase when walking and decrease when sitting, bending forward, or lying down.

• Rare: Bladder or bowel problems, paraplegia.

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Article written 04/14/2004
Published online 04/21/2004
Last updated 05/15/2007

I had a great pleasure reading Dr. Stewart Eidelson's 5-part article on spinal stenosis. The information included in this article is accurate and informative. I would like add a few comments for the benefit of the readers or potential patients. First, spinal stenosis is indeed most common in the lumbar spine, followed by the cervical spine. However, occasionally, the thoracic spine is affected as well. Spinal stenosis in the thoracic spine can present with pain radiating around the rib (thoracic radiculopathy) or numbness, spasm, and weakness of the legs (myelopathy). Sometimes, lumbar stenosis and cervical stenosis co-exist, and the astute doctor will pickup both diagnoses and render appropriate treatment for both conditions. Also, leg symptoms and walking difficulty may be due to clogging of the leg vessels (vascular claudication) rather than due to lumbar spinal stenosis (neurogenic claudication). Sometimes, both vascular and neurogenic claudication conditions may co-exist. Again, making the correct diagnosis is important for subsequent treatment.

As Dr. Eidelson mentioned, lumbar stenosis is largely due to "wear and tear" or degenerative changes in the joints and intervertebral discs in the spine over many years, but some patients are born with smaller spinal canal (congenital stenosis). Congenital stenosis patients typically show symptoms in their 40s and 50s rather than in their 60s and beyond. Because of smaller canals at birth, minor bulging discs and degenerated joints tend to affect the nerves earlier in life in these patients. Some patients with congenital stenosis may undergo discectomy alone without decompressive procedures for the narrowed canal, and surgical outcomes may be compromised. Again, correct and precise diagnosis leads to correct treatment.

Howard S. An, MD

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