Spinal Stenosis

A narrowing of the spine that puts pressure on the spinal cord and causes pain. Spinal stenosis usually affects people over the age of 50 and is more common in women. It is most often the result of osteoarthritis (OA) in the spine but has many other possible causes, including herniated disks, inflammatory arthritis, spinal tumors, injury to the spine, Paget disease, ligament degeneration, and genetic disposition (some people are born with a narrower spinal canal).

The spinal cord passes through the spinal canal, which is enclosed by the bones (vertebrae) of the spine. In spinal stenosis, either the spinal canal itself or the small canals where nerves branch out from the spine may narrow. Often the first symptom of spinal stenosis is pain, numbness, or cramping in the legs and lower back — this pain may diminish when a person is seated. Other symptoms may include pain, numbness, or cramping in the arms, feet, or neck and shoulder area. Furthermore, if the nerves of the lower back are under pressure (a condition called cauda equina syndrome), there may be loss of bowel or bladder control and severe weakness or loss of feeling in the groin area and the legs. Anyone experiencing these symptoms should call a doctor immediately.

Doctors can sometimes diagnose spinal stenosis based on a person’s medical history and a physical examination. The doctor may order one or more imaging tests, such as an x-ray, a magnetic resonance imaging (MRI) test, a computerized tomography (CT) scan, a myelogram, or a bone scan to see if there is narrowing of the spine.

Frequently people will use nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve) to relieve the pain of spinal stenosis. Regular exercise, which can include walking, stretching, biking, and swimming, is another good treatment. Physical therapy and a back brace are further options. However, if the symptoms are very serious or if other treatments do not work, surgery may be needed to widen the spinal canal and relieve pressure on the spinal cord.

Robert S. Dinsmoor is a medical writer and editor based in Massachusetts.

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