Spinal Stenosis FAQs

What is spinal stenosis?

Spinal stenosis is a condition where the spaces within the spine narrow, putting pressure on the spinal cord and nerves, leading to symptoms such as pain, weakness and numbness. This narrowing can occur in any part of the spine but is most common in the lower back (lumbar spine) and neck (cervical spine).

Foraminal stenosis is a specific type of spinal stenosis where the foramen, the small openings between the vertebrae through which spinal nerves exit the spinal column, become narrowed. This narrowing compresses the nerves, leading to symptoms.

Who gets spinal stenosis?

Anyone can get spinal stenosis; however, the chances of developing the disorder increase with age. Spinal stenosis also can be present in younger people who are born with a narrow spinal canal or who have an injury to the spine.

How common is spinal stenosis?

Spinal stenosis is relatively common, particularly in individuals over 50. It is estimated that about 11% of people in the general population experience some form of spinal stenosis, with prevalence increasing with age. Lumbar spinal stenosis the leading diagnosis for sdults over age 65 undergoing spine surgery.

What causes spinal stenosis?

The most common cause of spinal stenosis is age-related degeneration, such as osteoarthritis, which leads to the thickening of ligaments, formation of bone spurs, and herniated discs. Aging and age-related changes in the spine, injury, other diseases, or inherited conditions can cause narrowing of the spaces. Other causes include congenital spinal canal narrowing, injuries, tumors, or Paget’s disease of bone. Scoliosis can also lead to spinal stenosis.

What are the symptoms of spinal stenosis?

Symptoms depend on the location of the stenosis. Severe cases of stenosis can lead to problems with balance, walking, or bladder and bowel control.

1. In the lower back symptoms include:

• pain in the low back
• burning pain and aches that radiate down the buttocks into the legs that typically worsens with standing or walking and gets better with leaning forward.
• numbness, tingling, or cramping in the legs and feet, that is aggravated with standing or walking
• weakness in the legs and feet

2. In the neck, it can cause neck pain, numbness or tingling that radiates down the arms into the hands, and weakness in the arms.

How is spinal stenosis diagnosed?

Dr. Girardi will ask about your medical and family history and your symptoms, when they began and the location of symptoms. He will perform an orthopedic physical exam including your testing neurological function such as sensations, muscle strength, and reflexes in the arms and legs, your balance and gait. Dr. Girardi will order imaging tests including X-rays, MRIs, or CT scans.

What is the difference between lumbar and cervical stenosis?

Lumbar stenosis affects the lower back and is more common, typically causing symptoms like leg pain, numbness, and difficulty walking. Cervical stenosis affects the neck and can cause arm pain, tingling.

Can spinal stenosis get worse over time?

Yes, spinal stenosis can worsen as degenerative changes in the spine progress. Without treatment, the narrowing can continue to constrict the

spinal cord or nerves, leading to increased pain and neurological symptoms, such as numbness, weakness, and loss of motor function.

Is there a cure for spinal stenosis?

There is no cure for spinal stenosis, but treatments are available to manage the symptoms. Depending on the severity, these may include physical therapy, medications, and in more advanced cases, surgical intervention to relieve the pressure on the spinal cord or nerves.

What are the non-surgical treatments for spinal stenosis?

Nonsurgical treatments include physical therapy to improve flexibility and strengthen muscles supporting the spine including the core, medications like NSAIDs or muscle relaxants for pain relief, and epidural steroid injections to reduce inflammation around the nerves. Activity modification and posture improvements are also recommended to manage symptoms. Acupuncture and chiropractic may help relieve pain.

When is surgery necessary for spinal stenosis?

Surgery is recommended when nonsurgical treatments fail to relieve symptoms or if the condition is causing significant neurological impairments, such as difficulty walking, loss of bladder or bowel control, or severe pain that interferes with daily activities. Common procedures include laminectomy, discectomy, or spinal fusion.

What is the success rate of surgery for spinal stenosis?

Surgical treatment for spinal stenosis is often successful, particularly when performed to relieve pressure on nerves. Studies report that around 70-90% of patients experience improvement in pain and function following surgery. However, outcomes depend on the patient’s overall health, the severity of the condition, and the type of surgery performed.

Can spinal stenosis lead to paralysis?

In rare cases, particularly with severe cervical stenosis, untreated pressure on the spinal cord can lead to permanent nerve damage, which may result in loss of motor function or even paralysis. Immediate medical attention is necessary if symptoms like severe weakness or loss of bladder or bowel control occur.

Are there lifestyle changes that can help manage spinal stenosis?

Yes, lifestyle changes like maintaining a healthy weight, engaging in regular low-impact exercises (such as walking, swimming, or cycling), and practicing good posture can help reduce symptoms and slow the progression of spinal stenosis. Avoiding high-impact activities that stress the spine is also beneficial.

Can spinal stenosis be prevented?

While spinal stenosis caused by age-related degeneration cannot be completely prevented, measures like staying physically active, maintaining good posture, and keeping a healthy weight can help reduce the risk or delay the onset of symptoms. Preventing injuries to the spine and managing conditions like osteoporosis are also important.

Contact Dr. Girardi to schedule a consultation to learn more about your condition and discover all you treatment options. Dr. Girardi offers personalized expert orthopedic care to patients in New York, New Jersey, Connecticut and the Capital District Region, as well as international patients.

References

• https://www.niams.nih.gov/health-topics/spinal-stenosis
• Raja A, Hoang S, Patel P, et al. Spinal Stenosis. [Updated 2023 Jun 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441989/