Spinal Stenosis: Causes, Symptoms, and Treatment

Your spine plays a key role in every move you make. From bending over to reaching for a pen, your spine allows you to navigate the world. However, all of this movement can cause wear and tear over time. You may develop osteoarthritis as you age or experience a herniated disc after lifting heavy objects. One condition that can form due to this wear and tear is spinal stenosis. This condition has different levels of severity depending on its cause and there are multiple treatment methods.

Learn more about spinal stenosis and how Dr. Todd H. Lanman, one of the leading spinal neurosurgeons in the country and founder of the Advanced Disc Replacement Spinal Restoration Center, works to diagnose and treat this source of pain.

What is Spinal Stenosis?

Your spine provides support to your core, but it also serves as a superhighway for your nervous system. Countless nerves travel down your spine and command your hips, legs, and feet. These nerves allow you to move and enable you to feel pain and pleasure. When a red ant bites your foot, you can thank your nervous system for sending warning signals through pain.

At times, however, the spinal nerve superhighway can get damaged – not unlike a crash on an actual interstate. Spinal stenosis is a condition where the space within your spine becomes narrow, allowing your vertebrae to push into your nerve roots and spinal cord. Patients with spinal stenosis will notice a dull ache in their back and lower body or they can experience severe, sharp pains that seem to occur at random times.

What Causes Spinal Stenosis?

There are several different causes of spinal stenosis, both due to genetic conditions and lifestyle factors. This is because the spine is an incredibly complex part of your body with several moving pieces. Not only do you need to care for your vertebrae, but also your spinal discs, ligaments, joints, and nerves. When one of these elements is inflamed or out of place, you can experience severe pain.

Spinal stenosis is often the result of a previous injury or existing condition. It is something that you may need to treat on top of your arthritis, herniated disc, or bone spurs. Below are a few common causes of spinal stenosis and how they narrow your spinal canal.

Common Causes of Spinal Stenosis

Bone spurs: These occur when your bones continue to grow, creating bumpy projections where there should otherwise be a smooth surface. These often pop up near the joints, which can make bone spurs incredibly painful.

Osteoarthritis: This is known as the “wear and tear” of your bones. Over time, the cartilage that protects your vertebrae breaks down, causing the bones to rub together. The body tries to grow new bone as a form of defense, which creates bone spurs.

Rheumatoid arthritis: Also known as RA, rheumatoid arthritis is an autoimmune disease that attacks healthy cells in your body, particularly around your joints. This causes inflammation and sensitivity.

Bulging or herniated disc: Each of your vertebrae is projected by spinal discs, which are soft cushions that keep your bones from rubbing together. When one of these discs breaks or gets pushed from the spine, it can hit the nerves in your back, causing spinal stenosis.

Thickened ligaments: Your ligaments are bands of tissue that hold your bones, joints, and tissue in place. As you age, your ligaments may start to thicken and push into your spinal canal.

Spinal cysts or tumors: Cysts and tumors are unwanted growths in your body. You may develop a tumor or other growth that pushes into your spinal canal, causing pain.  

Genetics: some people may be more prone to developing a narrow spinal canal than others because of their DNA.

Injury to the spine: a fresh injury can lead to spinal stenosis if the passageway for the nerves is narrowed. Injuries can stem from a variety of causes, including sports, car accidents, and excessive manual labor.

Past surgery on the spine: Spinal stenosis can also become an issue after back surgery. If your body does not accept the treatment or the procedure is not done well, your spinal passageways could be limited.

Certain bone diseases: Spinal stenosis is often the result of other bone diseases, rather than an isolated disease itself. Dr. Lanman will work to identify the main cause of your condition before developing a plan of treatment.

Is Spinal Stenosis a Permanent Disability?

Every patient is unique, which means that some cases of spinal stenosis will be more severe than others. Spinal stenosis may become a permanent disability in some cases, but not always.

The first step toward preventing spinal stenosis from becoming permanent is to identify the cause of the issue. If your nerve pain is caused by a treatable condition, then Dr. Lanman may take steps to reduce the pressure in your spine. One of the best ways to treat this condition is to catch it when the pain is still mild. The earlier Dr. Lanman can diagnose your spinal stenosis, the better chance you have of living with your full range of motion.

Even with early intervention and high-quality care, your symptoms of spinal stenosis may persist. In some patients, spinal stenosis becomes serious enough that they are no longer able to work. If this is the case, you may be able to apply for disability benefits because of the injury.

Dr. Lanman will do his best to free you from the chronic pain and spinal stenosis symptoms that prevent you from living a fulfilling life. He will try multiple options to determine which methods work best for your case. However, as in all surgeries, every patient’s case is unique and results are not guaranteed.

Symptoms of Spinal Stenosis

There are several symptoms of spinal stenosis you should be aware of. You may experience some of these symptoms more frequently than others. You might not experience some of these symptoms at all. Talk to Dr. Lanman if you live with any of the following:

1. Neurogenic claudication: this refers to leg heaviness or pain, especially when walking. You may experience pain, tingling, cramping, or other symptoms that make it difficult to move one or both legs. These symptoms can be found throughout the leg or in targeted areas near the thighs.
2. Sciatica: spinal stenosis may affect the sciatic nerve, which runs through your hips and down each leg. Sciatica refers to pain that is caused by damage or pressure on this particular nerve.
3. Foot drop: this refers to difficulty being able to lift the front part of your foot. As a result, you may have to drag your feet to walk and experience trouble moving them around.
4. Gait problems: moving may become painful with spinal stenosis, resulting in changes to your gait. You may walk in a more halting manner or place your weight in different ways to move. Gait changes can cause additional pain in your legs and back because your body is off balance.
5. Radiating arm pain: spinal stenosis doesn’t just affect the legs. You may also experience pain down your arms if your nerves are affected in the cervical part (neck area) of your spine.
6. Loss of fine motor skills: your fine motor skills help you navigate the world each day. You use them to hold a pen, use a spoon to eat soup, and cut vegetables for dinner. These small activities may become challenging with spinal stenosis.
7. Bowel or bladder incontinence: If your body is unable to communicate with your brain due to spinal issues, you may have trouble controlling your bowels and bladder over time.
8. Numbness in the inner thighs and genital area: this is another symptom of nerve damage; your brain cannot read the messages that your nerves are sending because of the narrowing of the spinal canal.
9. Severe weakness in both legs: basic tasks, like walking and lifting, may seem nearly impossible with spinal stenosis. You may feel weak to the point where you don’t want to move.

The types of symptoms you experience will depend on which nerves are affected by spinal stenosis. If the problem persists, meaning your spinal canal becomes even more impacted, your existing symptoms may become worse or you may develop new ones as different nerves become affected.

What are the final stages of spinal stenosis that make surgery necessary?

Over time, your spinal stenosis symptoms may get worse. This is because the cause of your condition is growing more severe. For example, a bulging or herniated disc could continue to push into the spinal canal, affecting more nerves. At some point, non-surgical treatments might not be an option. A few signs that you might need surgical intervention include:

• Numbness
• Weakness
• Imbalance
• Bowel and bladder incontinence
• Paralysis
• Permanent disability

If you experience these symptoms, seek treatment through Dr. Lanman. You may be a candidate for surgery to reduce your side effects and target the source of your pain.

Diagnosing Spinal Stenosis

The first step toward healing when you suspect that you have spinal stenosis is securing a diagnosis. Your doctor wants to understand the source of your pain and how it affects other parts of the body.

When you first meet with Dr. Lanman, he will want to get to know you. He might ask questions about the type of work you do (if there is heavy lifting involved) and which hobbies you enjoy. These questions provide insight into your lifestyle and the potential risks that come with doing surgery.

Based on his analysis of your condition, Dr. Lanman might request a series of tests to provide a clear view of your spine. A few common tests include:

• X-Rays: an x-ray will take pictures of your bones and will highlight any issues with your vertebrae. For example, if you have bone spurs, the growths should be visible in these images.
• Magnetic Resonance Imaging (MRI): this test uses magnets and radio waves to take pictures of different parts of your body. With an MRI, Dr. Lanman can check to see if your disks or ligaments are damaged. This test will also highlight your nerves, to see where the compression is taking place.
• Computerized Tomography (CT) scan: this test can be an alternative to an MRI. Some doctors may recommend a CT myelogram, in which a contrast dye is injected into your body to outline the spinal cord and nerves.

One or more of these tests may be necessary to receive a full diagnosis for your spinal stenosis. Dr. Lanman needs a clear picture of what is happening in your body before he can create a plan to reduce your pain levels.

What is the Best Treatment for Spinal Stenosis

There is good news for people who live with spinal stenosis: there are multiple treatment options available – including surgical procedures. Many modern spinal procedures are considered outpatient appointments, which means you won’t have to stay overnight to recover.

Patients who receive care from Dr. Lanman do not have to visit a hospital for surgery. Most operations are completed within a few hours and you can return home to recover almost immediately after.

Should I Have Surgery for Spinal Stenosis?

Multiple factors contribute to whether a patient should have surgery for spinal stenosis. The first is their health and lifestyle. Even a minimally-invasive procedure requires downtime and places burdens on your immune system to heal. Dr. Lanman wants to make sure you can recover promptly.

The next thing to consider is the severity of your case. Mild cases of spinal stenosis may be treatable with physical therapy or medication. However, if your case is growing more severe, Dr. Lanman may recommend surgical intervention.

Finally, Dr. Lanman wants to ensure that surgery will address the issue. While most spine operations have high success rates, there are instances where patients still experience pain after their procedures. Even if you are considered a candidate for surgery, it is important to work with a leading spinal surgeon to confirm that an operation is the best choice for your care.

Surgery Options:

Your surgical options will depend on the location of your spinal stenosis. A few common procedures that today’s doctors recommend include:

• Laminectomy: this procedure removes the back part of your vertebrae, called the lamina. This removal reduces pressure on your spine, allowing your spinal canal to expand. With a laminectomy, your nerves will no longer feel pinched because of the tight space.
• Laminotomy: while a laminectomy removes most (if not all) of the lamina, the laminotomy only removes a portion of the bone. The goal is to carve a hole that is just big enough to remove pressure from your spine.
• Laminoplasty: in this procedure, part of the lamina is removed. A plate is then added to bridge the space where the lamina previously was. A laminoplasty option is only used in the cervical spine (the neck).
• Minimally invasive surgery: the goal of this option is to remove as little bone or lamina as needed to reduce pain in the patient’s back. By reducing the invasiveness of the surgery, doctors can decrease the chances of complications in the healing process (like infections) and reduce the expected recovery time.

How do You Treat Spinal Stenosis Without Surgery

Not everyone is a candidate for surgery. Some people are unable to physically handle the stress that surgery puts on their bodies. Other patients have mild cases of spinal stenosis and can treat their symptoms without surgical methods.

If possible, Dr. Lanman tries to avoid recommending surgery when he thinks non-surgical options will suffice. As you discuss your spinal stenosis with him, he may recommend one or multiple of the following treatments:

• Medications: pain medications work by targeting your nerves. When you experience pain, your body sends warning signals through your nerves, up your spine, and to your brain. The chemicals in pain relievers block these signals so you don’t experience as much pain.
• Steroids: steroids work by reducing activity in the immune system and reducing inflammation. When your body receives warning signals that something is wrong, you feel pain. Your immune system creates white blood cells to protect the area – leaving it tender and swollen. Steroids can reduce this white cell production, which means there will be less swelling around your spine and joints.
• Physical therapy: if you experience spinal stenosis, you can either attend physical therapy or complete daily exercises at home, depending on your needs. This form of therapy involves a series of stretches and movements to improve your spinal health and grow your back muscles, opening your spinal canal over time.
• Massage therapy: like physical therapy, massage therapy is a hands-on treatment to reduce the effects of spinal stenosis. A qualified massage therapist can apply pressure to targeted areas where you feel pain. Massage therapy supports the muscles around your spine and can reduce your pain levels.
• Chiropractic treatment: chiropractors work on your spine to make sure your vertebrae are aligned. Depending on the cause of your spinal stenosis, Dr. Lanman may recommend chiropractic care to ensure you have good spinal health.
• Acupuncture: acupuncture is the process of inserting very fine needles into strategic points of the body. This treatment stimulates your central nervous system and causes your brain to release certain chemicals throughout the body. These chemicals make you feel better and stimulate healing.

Dr. Lanman will likely recommend multiple treatments to care for your spinal stenosis. For example, pain medication may help immediately to treat discomfort, but quality physical therapy exercises can help you improve your range of motion in the long run. Both options could be beneficial to your needs.

Commonly Asked Questions

It’s understandable to have concerns about your Spinal Stenosis treatment. Here are a few frequently asked questions that patients bring to Dr. Lanman when they meet to discuss their back pain.

What is the best exercise for spinal stenosis?

There are multiple exercises that you can do to ease back pain. The best exercises are considered low-impact, which means your body can move without placing pressure on the spine. Swimming and biking are two popular exercise options for people living with back pain. Dr. Lanman may also recommend a few targeted exercises to build your muscles and stretch out your back.

Can CBD oil help spinal stenosis?

Cannabidiol (CBD) is derived from the cannabis plant. Some studies show that this oil can reduce the pain levels in your back. However, talk to Dr. Lanman about the oil you use and its potential effectiveness.

Can spinal stenosis cause the inability to walk?

Spinal stenosis comes with different levels of severity. When you first start to notice your symptoms, you may experience back pain and a reduced range of motion. Over time, as the nerve damage worsens, you may have difficulty moving your feet, walking, and even controlling your bowels and bladder. This is why it’s important not to leave your spinal stenosis symptoms untreated.

How does spinal stenosis affect the legs?

Your spine is a central hub for nerves that travel through your body. When you want to walk or move your legs, your brain sends a message down your spinal canal and into the nerves in your legs. When these nerve highways are blocked by spinal stenosis, it is harder for your brain to send these messages. In severe cases, patients can lose feeling in their legs and eventually experience paralysis.

At what age do people usually get spinal stenosis?

While spinal stenosis can occur at almost any age, it is more common in aging adults. The majority of people who develop symptoms related to spinal stenosis are 50 years or older.

Take Steps to Treat Your Back Pain

You don’t have to live with back pain. Spinal stenosis is often the result of other conditions affecting your spine, like a herniated disc or bone spurs. Dr. Lanman takes a high-level approach to evaluate the health of your spine and the sources of your pain. From there, he will develop a treatment plan that includes non-surgical options and potential surgical intervention.

Don’t let your spinal stenosis symptoms reduce your quality of life. Request a consultation.