What causes it?
Over time, discs flatten and bulge, joints enlarge with arthritis, ligaments thicken and bone spurs form. Together these narrow the spinal canal or the openings where nerves exit.
Symptoms
- Lower back stenosis: pain, heaviness or numbness in the legs when standing or walking, eased by sitting or leaning forward
- Needing to rest after walking a short distance
- Neck stenosis: neck pain, arm symptoms, clumsy hands or problems with balance
How it is diagnosed
An examination and an MRI show where the narrowing is and how much pressure there is on the nerves or spinal cord. X-rays taken while bending can show whether the spine is also unstable.
Treatment
Physical therapy, medication and injections help many patients stay active. When symptoms limit walking or daily life, a decompression (laminectomy or laminotomy) removes the bone and ligament pressing on the nerves. This can often be done with minimally invasive techniques.
If a vertebra has slipped or the spine is unstable, a fusion may be added to stabilize it.
Stenosis in the neck that presses on the spinal cord (cervical myelopathy) is treated more urgently, because the goal is to prevent permanent loss of hand function and balance.
Common questions
Does spinal stenosis always need surgery?
No. Many people manage symptoms well with exercise, therapy and occasional injections. Surgery is an option when walking distance or quality of life keeps getting worse.
Why does leaning forward help?
Bending forward opens the spinal canal slightly and takes pressure off the nerves. That is why many people with lumbar stenosis feel better leaning on a shopping cart.
This page is general information reviewed by Dr. Amos O. Dare and is not a substitute for a medical evaluation.