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Spinal stenosis

Definition

Spinal stenosis is narrowing of the spinal column that causes pressure on the spinal cord, or narrowing of the openings (called neural foramina) where spinal nerves leave the spinal column.

Alternative Names

Pseudo-claudication; Central spinal stenosis; Foraminal spinal stenosis; Degenerative spine disease; Back pain - spinal stenosis; Low back pain - stenosis; LBP - stenosis

Causes

Spinal stenosis usually occurs as a person ages.

  • The spinal disks become drier and start to bulge.
  • The bones and ligaments of the spine thicken or grow larger. This is caused by arthritis or long-term swelling.

Spinal stenosis may also be caused by:

  • Arthritis of the spine, usually in middle-aged or older people
  • Bone diseases, such as Paget disease
  • Defect or growth in the spine that was present from birth
  • Narrow spinal canal that the person was born with
  • Herniated or slipped disk, which often happened in the past
  • Injury that causes pressure on the nerve roots or the spinal cord
  • Tumors in the spine
  • Fracture or injury of a spinal bone

Symptoms

Symptoms often get worse slowly over time. Most often, symptoms will be on one side of the body, but may involve both legs.

Symptoms include:

  • Numbness, cramping, or pain in the back, buttocks, thighs, or calves, or in the neck, shoulders, or arms
  • Weakness of part of a leg or arm

Symptoms are more likely to be present or get worse when you stand or walk. They often lessen or disappear when you sit down or lean forward. Most people with spinal stenosis cannot walk for a long period.

More serious symptoms include:

  • Difficulty or poor balance when walking
  • Problems controlling urine or bowel movements

Exams and Tests

During a physical exam, your health care provider will try to find the location of the pain and learn how it affects your movement. You will be asked to:

  • Sit, stand, and walk. While you walk, your provider may ask you to try walking on your toes and then your heels.
  • Bend forward, backward, and sideways. Your pain may worsen with these movements.
  • Lift your legs straight up while lying down. If the pain is worse when you do this, you may have sciatica, especially if you also feel numbness or tingling in one of your legs.

Your provider will also move your legs in different positions, including bending and straightening your knees. This is to check your stren