Stenosis is a medical term that means “narrowing.” In spinal stenosis, the open spaces in the spine that provide a conduit for nerves become narrower, which means there’s less room for these nerves as they travel from the brain to other areas of the body. As the condition progresses, the nerves eventually become crowded and compressed, resulting in pain and other symptoms. Spinal stenosis is more common among older men and women, occurring as a result of age-related or degenerative diseases of the spine. Arthritis and hard projections called bone spurs are common causes of spinal stenosis. Less often, spinal stenosis can occur in people whose spinal columns are naturally narrow. Stenosis is most common in the neck or cervical spine, or in the lower back or lumbar spine.
Mild stenosis may cause very few symptoms or no symptoms at all. When symptoms do occur, they may be mild or intermittent. As the disease progresses, it can cause symptoms like pain in the back or neck, or pain, numbness, tingling or weakness in the arms or legs. Temporary relief may be achieved by sitting down and leaning forward to help open the spinal space. In very severe cases, stenosis can affect the nerve pathways that travel to the bladder or bowels, causing symptoms of incontinence. Without proper treatment, stenosis symptoms tend to become worse over time as degeneration and narrowing continues.
Prior to treatment, patients will undergo a series of evaluations, including a physical examination of the back, a thorough patient history, and review of symptoms, and imaging tests which can include x-rays, MRIs or CT scans to confirm the diagnosis and rule out other conditions that can cause similar symptoms. Very mild stenosis may respond to physical therapy and medication to relieve inflammation and pain and improve overall mobility. More advanced cases of stenosis may require injections or IVs to the space surrounding the spine (the epidural space) to deliver anti-inflammatory medications. Patients with severe stenosis may require surgery to remove bone or bone spurs so compression is relieved.