Spinal Stenosis – Causes, Symptoms, Treatment, Surgery

Spinal Stenosis occurs when the cervical spine or lumbar spine is compressed. Due to extra pressure applied within the spine, the existing open spaces get compressed. This in turn puts pressure on the nerves traveling through the spinal cord transmitting pain in the neck and lower back region. The term “stenosis” means choking in Greek and here the open spaces available in the spine is compressed. Spinal stenosis can cause pain in the leg or tingling sensation. Cervical stenosis causes pain in your arm. Anti-inflammatory drugs, physiotherapy and epidural injections are the available treatment for spinal stenosis. In severe cases surgery may also be done.

Spinal Stenosis Types :

Spinal stenosis is of two types namely lumbar and cervical stenosis. Lumbar stenosis is quite common and Cervical Spinal Stenosis is rare and dangerous since it involves the spine directly. In severe cases of lumbar stenosis it can cause persistent pain and weakness of legs. Depending on the part of the spine compression, spinal stenosis can be further divided into 3 types.

• Foraminal Stenosis :

It is the most commonly occurring spinal stenosis in which the nerve root gets compressed by the existing bone spur (osteophyte) originating from the degenerating disc. Here the nerve root would normally leave the spine through lateral foramen (side hole) which becomes impossible due to the development of bone spur. This type of stenosis often develops at the lowest lumbar spine.

• Central Stenosis :

In this type the central canal area would compress the nerve roots of the cauda equina or horse’s tail portion. This condition often occurs in the second lowest lumbar spine and due to the overgrowth of disc margin and its ligaments.

• Far Lateral Stenosis :

This is a rare type of spinal stenosis wherein the nerve gets compressed by the bony spur or Bulging Disc after it has emerged from the spine. All the above stenosis are types of spinal stenosis and named on the basis of its anatomy.

Spine Structure :

Spinal cord is made up of hundreds of tiny bony structures and attachments that give durability to the spine. It also protects the spine and the nerve groups that pass down from the brain to all parts of the body. Spinal segment is the term given to group of vertebral body together with its attachments. There are spaces or holes in each side of the central canal through which nerve endings emerge from the spine. Such holes exist at each level of the central canal. When these hole spaces are compressed by the bulging disc the spinal cord along with nerve roots gets affected causing spinal stenosis. More than 70% of stenosis occurs in the lower back (lumbar spine) causing pain in the back of the leg.

Spinal Stenosis Symptoms :

Spinal stenosis do not produce any symptoms in many people. In some cases signs of pain starts gradually and gets worse over time. Symptoms of spinal stenosis vary according to the location of the spine that gets compressed. Some of these symptoms include weakness of leg, arm and foot and tingling sensation. Some people may feel imbalance in walking and they walk clumsily with pain and in rare cases bowel movements can also get affected when the nerve endings of the bladder gets compressed. For some people stenosis can cause cramps in the legs especially when they are in standing position for long duration.

Spinal Stenosis Causes :

Many factors can cause spinal stenosis. Some people are born with defective spinal canal. But in most of the cases compression of space is the main cause for stenosis. Prolonged osteoArthritis can cause wear and tear of bones gradually leading to the formation of bone spur. Bone spur will eventually occupy the available space exerting pressure over the spine and nerve roots. Paget’s disease may also be a reason for spinal stenosis.

Herniated disk can cause stenosis over time. Soft cushions present in the spine may wear as one grows forming cracks pushing the soft matter outside. This would build pressure on the spinal cord causing stenosis. Ligaments that bind the bones present in the spine can become tough and thick over time exerting pressure on the spine leading to spinal stenosis.

Development of any Tumor inside the spine would occupy the available space in the vertebral column exerting pressure. Any injury or trauma of the spine can cause fracture pushing the soft materials out of spinal canal. In rare cases spinal stenosis can cause weakness of spine and numbness on the affected part of the body like leg or hand. If the nerves leading to the bladder are collapsed it may cause incontinence.

Tests :

Since some of the symptoms of spinal stenosis is common with old age it is difficult to detect stenosis. Based on observation your doctor may request for imaging tests like X-rays, MRI or CT myelogram to get accurate picture of spinal stenosis.

Images, Pics, Photos and Pictures of Spinal Stenosis :

Spinal Stenosis Treatment :

Mild form of spinal stenosis needs no treatment. It is enough if you make changes in lifestyle. By making changes in posture one can get relief from the pain or tingling sensation in the legs. Instead of sitting for long duration one should walk for few minutes to regain flexibility. Bend your knees forward till the line of your chest slowly. This would relieve the nerves from compression. Over the counter painkillers like Brufen or aspirin can be taken to get quick relief from pain. Prescription medications include Amrix or Flexeril to manage muscle spasms. For those with unbearable Chronic Pain affecting the quality of sleep antidepressants like amitriptyline is recommended.

Anti seizure drugs like gabapentin and pregabalin are prescribed to control pain caused by damaged nerves. For managing severe pain opioids like Percocet or oxycontin are given in limited doses. Take complete rest from work if you have pain. This would heal the compression gradually. Physiotherapy is effective to manage pain and regain muscle strength and flexibility. Steroid injections are given directly into the open space of the spine to relieve the extra pressure and to control inflammation. But this should not be made regular.

In rare cases surgery is done to get rid of extra pressure on the nerves of the spine. Laminectomy procedure is done to build spine strength in which the back part of the affected spine is removed. In Laminotomy the surgeon would create enough space on the central canal so that pressure cannot be exerted on the spine. Metals are used to bridge the gap of the opened sections in the spine. However there is no guarantee that symptoms of lower back pain will be reduced after spine surgery. It may remain the same or even get worse. For mild form of spinal stenosis over the counter anti-inflammatory agents like Advil or Motrin or Aleve can be taken. You can apply ice pack or hot water pack on the area. To maintain the posture while walking, you can use walkers for additional support.

Excellent Spinal Stenosis Exercises to Try

Excellent Spinal Stenosis Exercises to Try

Spinal stenosis occurs when the spinal cord and the nerve roots are compressed due to narrowing of the spinal canal. Stenosis or narrowing causes pinching of the nerve structures, which leads to severe pain, weakness and numbness of the affected parts. Depending on the level of the spine that is narrowed, corresponding parts of the body from the neck, down to the arms and legs may be affected.

Physical therapists and rehabilitation experts recommend spinal stenosis exercises to improve a patient’s strength and to increase the range of motion and flexibility of the spine and body. Exercises for spinal stenosis help reduce your symptoms of pain, stiffness, numbness, or tingling.

Spinal Stenosis Exercises
1. Cardiovascular Exercises
Stenosis of the spine exercises include cardiovascular exercises to get the heart pumping, to burn calories, and to help you maintain a healthy weight. Spinal stenosis exercises involve low impact exercises that are done in slow motion. These include swimming, walking and using an elliptical trainer. The bending forward position used when riding a bicycle widens the spinal canal and temporarily reduces pressure on the spinal nerves.

2. Leg Grab
The leg grab exercise helps widen the spinal canal. This can be done when you wake up or go to bed. To do this, lie flat on your back with your feet on the floor. Lifting your legs toward your chest, place your hands around your knees and pull them towards your chest. Feel your lower back stretch and hold the position for 15-30 seconds. Release the stretch then repeat twice.

3. Hook-Lying March
To strengthen the back muscles, lie flat on your back with feet on the floor. Place your arms straight on the floor with palms faced down. Lift the right leg slowly, about three to four inches off the floor. Lower your leg, at the same time lifting your left leg. Do this marching movement for 30 seconds then rest for another 30 seconds. Repeat until you complete four sets.

4. Stretches
Stenosis of the spine exercises also include stretches for the low back muscles (low back extensors), which hold your spine in a backward bending position. Also called Sciatica exercises, these include:

• Back flexion: While lying on your back, gently pull your knees to the chest until you feel a comfortable stretch. Hold for 30 seconds, and then slowly return to your starting position. Do four to six repetitions.


• Go down on your hands and knees. Sit back on your heels with your chest down and arms outstretched. Hold for 30 seconds, and then slowly return to original position. Do four to six repetitions. Avoid bouncing on your heels.

5. Strengthening Exercises

• While lying on your back, press the lower part of your back onto the floor. You can do this by tightening the muscles of the lower abdomen and pulling your belly button in and up. Hold this position for 10 seconds. Do eight to ten repetitions.


• Do curl-ups by folding your arms across the chest and flattening your back on the floor by tightening the lower abs. Now raise your head and shoulders from the floor. Hold this position for 2-4 seconds, and return to original position. As your strength builds up, try to complete two sets with ten curls each.

6. Other Exercises That May Help
Other spinal stenosis exercises that may help relieve your symptoms and prevent worsening of the condition include:

• Strengthening of the lower limbs to prevent falls


• Lower back stabilizing exercises and pelvic tilts


• Frequent changes of body position to avoid compression of the spine


• Frequent breaks from work


• Using proper techniques in lifting, pulling andpushing


• Yoga exercises, which include balancing, stretching, relaxing and breathing exercises


• Tai Chi, which involves slow, flowing body movements


• Bicycle riding or stationary biking

Your physical therapist or doctor will create a specific program to suit your physical fitness, level of activity, and severity of pain. You can also join a gym and work with a trainer/therapist to find an effective way of learning stretching and core strengthening exercises.

Are All Exercises Good for Spinal Stenosis?
Not all exercises are beneficial in reducing spinal stenosis symptoms. Some activities place a lot of Stress on your back. Repetitive high impact exercises, such as jogging, tennis, football and basketball can hurt your spinal canal because your spine absorbs the impact. Choose low-impact activities such as swimming and walking to strengthen your muscles.

How Will Exercises Help Spinal Stenosis?

• Spinal stenosis exercises increase blood flow to your back, bring in oxygen and nutrients and wash away toxic metabolites.


• Exercising strengthens muscles around your spine and helps take off the pressure from the back.


• Exercising helps maintain flexibility and helps prevent tight muscles which can pull and torque your spine.


• Exercising helps get rid of excess weight, which can worsen back and leg pains.


• Staying active promotes mental and emotional health as well. Exercise increases blood flow and endorphin production, which improves your overall outlook and helps reduce physical symptoms.

Tips to Follow
A few tips to keep about exercises for spinal stenosis:

• Exercise regularly: Plan to ride the bicycle every day and make it part of your routine. Choose an activity that is fun, enjoyable and rewarding, preferably one that can be done in any weather condition.


• Always check with your doctor before starting a new exercise program. Your doctor may also recommend a physical therapist to help you learn ideal exercises that can become part of your daily routine.


• Avoid exercising through pain or other symptoms. If pain is caused or worsened by activity, stop and consult your doctor about it.

Spinal Stenosis Surgery Options and Recovery

Spinal Stenosis Surgery Options and Recovery

Your backbone or spine contains the spinal cord, from which the spinal nerves emanate. The spine is composed of individual bones or vertebrae that are separated by intervertebral discs. The discs serve as a cushion to absorb shock and the vertebrae are joined together through facet joints. As you grow older, the spinal canal can become narrower and bone spurs or osteophytes may grow into it. The facet joints can also become arthritic. These changes make the spinal canal narrower, and this condition is called spinal stenosis.

Spinal stenosis causes extreme back pain, as well as numbness and weakness of the lower extremities. Treatment often involves physical therapy and anti-inflammatory and pain medications, but some people need spinal stenosis surgery. Surgery for spinal stenosis is therefore used as a last resort for patients who are not able to work or function normally because of their spine problem.

Why Do You Need Spinal Stenosis Surgery?
Spinal stenosis surgery is often reserved for people who do not respond well to conservative treatments. Conditions whenlower back surgery options are considered include:

• Persistent symptoms in spite of non-surgical treatments


• Chronic severe pain


• Radiculopathy, a condition characterized by pain, tingling and numbness in the arms/legs


• Loss of sensation in the arms/legs


• Weakness in the arms/legs


• Loss of bowel/ bladder control

The main goal of surgery for spinal stenosis is to decompress your spinal cord and the nerve roots. Spinal decompression gives the spinal cord and the nerve roots more space, which reduces pain and other symptoms due to nerve inflammation. Spinal stenosis surgery also increases motor strength and restores sensation in your arms/legs.

Considerations Before Spinal Stenosis Surgery
The most important consideration for spinal stenosis surgery is for the surgeon to have a detailed anatomical knowledge of the areas of the spine involved. The surgery must cause minimal destruction of other normal structures, which is why it is important for the surgeon to have adequate knowledge of the exact structures involved in the procedure. It must be done carefully, so as not to create new problems that may result from nerve injury or structural instability.

Finally, the patient’s physical and metabolic status must be given attention to because decompression surgery may require a long period under general anesthesia, which may not be well-tolerated by certain patients. Some patients undergo spinal stenosis surgery under epidural anesthesia, but this also requires special care.

What Are the Options for Spinal Stenosis Surgery?
The lower back or lumbar area is most commonly involved in spinal stenosis because this is the area that is most likely to receive a lot of Stress from a person’s body weight and movements. Here are some of thelower back surgery options:

1. Foraminotomy
This procedure is done when a bone spur or intervertebral disc presses on a spinal nerve as it exits through a foramen (a hole in the vertebra). A foraminotomy makes the foramen bigger so that the nerve exits without compression.

2. Laminotomy
This procedure is similar to a foraminotomy in that it creates a bigger opening in the bony plate (the lamina) which protects your spinal cord. The lamina, which may be pressing on a nerve, is decompressed to make more room for your nerves.

3. Laminectomy
If laminotomy does not sufficiently cause decompression, the surgeon may remove part or all of the lamina, a procedure called laminectomy. This spinal stenosis surgery can be done at any level without harmful effects.

4. Spinal Fusion
In severe cases of spinal stenosis, the surgeon decides to join the spinal bones together using bone grafts or screws to provide stability to the spine. It can be combined with a laminectomy. This surgery usually lasts several hours and it uses one of these methods:

• Bone may be removed elsewhere in your body or acquired from a bone bank. The bone graft is used to stimulate the growth of new bone and form a bridge between the vertebrae.


• Adjacent vertebrae are secured together using metal implants (rods, hooks, screws or wires) to hold them together while waiting for new bone to grow between them.

What About the Risks of Spinal Stenosis Surgery?
Spinal stenosis surgery carries potential risks, which are common to other types of surgery. Consult your doctor about these risks before signing a consent form for surgery. Possible risks and complications include:

• Risks associated with anesthesia


• Spinal cord or nerve injury


• Failure of healing of the bony fusion (pseudoarthrosis)


• Lack of improvement


• Breakage/failure of instrumentation


• Infection


• Pain at the site of the bone graft

Recovering from Spinal Stenosis Surgery
Recovery after spinal stenosis surgery may take some time. You may be out of bed in 24 hours, but you will need pain medications for two to four weeks. You will receive instructions about how rise, sit, and standcarefully. It is important to allow your body to heal, so you will be advised to restrict your activities. You must avoid activities that involve too much spine movements such as twisting, heavy lifting, as well as contact sports.

Right after surgery, it is important to be vigilant and to report problems such as fever, infection, orworsening pain. Seek medical help immediately if you have any of these problems.

Practice healthy habits following surgery. Here are some tips:

• Always follow the treatment plan suggested by your doctor.


• Always stand and sit properly.


• Learn the proper way to lift correctly.


• Exercise regularly, but stick to low-impact aerobic exercises. Ask your doctor before starting a new exercise regimen.


• Use proper exercise/sports equipment.


• Eat a well-balanced, low-fat diet that is rich in fruits and vegetables. Get enough calcium.


• Maintain a healthy body weight.


• Avoid taking alcohol in excess.


• Stop smoking.

Spinal Stenosis

Spinal Stenosis






Spinal stenosis occurs when the cervical spine or lumbar spine is compressed. Due to extra pressure applied within the spine, the existing open spaces get compressed. This in turn puts pressure on the nerves traveling through the spinal cord transmitting pain in the neck and lower back region. The term “stenosis” means choking in Greek and here the open spaces available in the spine is compressed. Spinal stenosis can cause pain in the leg or tingling sensation. Cervical stenosis causes pain in your arm. Anti-inflammatory drugs, physiotherapy and epidural injections are the available treatment for spinal stenosis. In severe cases surgery may also be done.

Types :

Spinal stenosis is of two types namely lumbar and cervical stenosis. Lumbar stenosis is quite common and Cervical Spinal Stenosis is rare and dangerous since it involves the spine directly. In severe cases of lumbar stenosis it can cause persistent pain and weakness of legs. Depending on the part of the spine compression, spinal stenosis can be further divided into 3 types.

• Foraminal stenosis :

It is the most commonly occurring spinal stenosis in which the nerve root gets compressed by the existing bone spur (osteophyte) originating from the degenerating disc. Here the nerve root would normally leave the spine through lateral foramen (side hole) which becomes impossible due to the development of bone spur. This type of stenosis often develops at the lowest lumbar spine.

• Central Stenosis :

In this type the central canal area would compress the nerve roots of the cauda equina or horse’s tail portion. This condition often occurs in the second lowest lumbar spine and due to the overgrowth of disc margin and its ligaments.

• Far Lateral Stenosis :

This is a rare type of spinal stenosis wherein the nerve gets compressed by the bony spur or Bulging Disc after it has emerged from the spine. All the above stenosis are types of spinal stenosis and named on the basis of its anatomy.

Spine Structure :

Spinal cord is made up of hundreds of tiny bony structures and attachments that give durability to the spine. It also protects the spine and the nerve groups that pass down from the brain to all parts of the body. Spinal segment is the term given to group of vertebral body together with its attachments. There are spaces or holes in each side of the central canal through which nerve endings emerge from the spine. Such holes exist at each level of the central canal. When these hole spaces are compressed by the bulging disc the spinal cord along with nerve roots gets affected causing spinal stenosis. More than 70% of stenosis occurs in the lower back (lumbar spine) causing pain in the back of the leg.

Symptoms :

Spinal stenosis do not produce any symptoms in many people. In some cases signs of pain starts gradually and gets worse over time. Symptoms of spinal stenosis vary according to the location of the spine that gets compressed. Some of these symptoms include weakness of leg, arm and foot and tingling sensation. Some people may feel imbalance in walking and they walk clumsily with pain and in rare cases bowel movements can also get affected when the nerve endings of the bladder gets compressed. For some people stenosis can cause cramps in the legs especially when they are in standing position for long duration.

Causes :

Many factors can cause spinal stenosis. Some people are born with defective spinal canal. But in most of the cases compression of space is the main cause for stenosis. Prolonged osteoarthritis can cause wear and tear of bones gradually leading to the formation of bone spur. Bone spur will eventually occupy the available space exerting pressure over the spine and nerve roots. Paget’s disease may also be a reason for spinal stenosis.

Herniated disk can cause stenosis over time. Soft cushions present in the spine may wear as one grows forming cracks pushing the soft matter outside. This would build pressure on the spinal cord causing stenosis. Ligaments that bind the bones present in the spine can become tough and thick over time exerting pressure on the spine leading to spinal stenosis.

Development of any tumor inside the spine would occupy the available space in the vertebral column exerting pressure. Any injury or trauma of the spine can cause fracture pushing the soft materials out of spinal canal. In rare cases spinal stenosis can cause weakness of spine and numbness on the affected part of the body like leg or hand. If the nerves leading to the bladder are collapsed it may cause incontinence.

Tests :

Since some of the symptoms of spinal stenosis is common with old age it is difficult to detect stenosis. Based on observation your doctor may request for imaging tests like X-rays, MRI or CT myelogram to get accurate picture of spinal stenosis.

Images, Pics, Photos and Pictures of Spinal Stenosis :

Treatment :

Mild form of spinal stenosis needs no treatment. It is enough if you make changes in lifestyle. By making changes in posture one can get relief from the pain or tingling sensation in the legs. Instead of sitting for long duration one should walk for few minutes to regain flexibility. Bend your knees forward till the line of your chest slowly. This would relieve the nerves from compression. Over the counter painkillers like Brufen or aspirin can be taken to get quick relief from pain. Prescription medications include Amrix or Flexeril to manage muscle spasms. For those with unbearable Chronic Pain affecting the quality of sleep antidepressants like amitriptyline is recommended.

Anti seizure drugs like gabapentin and pregabalin are prescribed to control pain caused by damaged nerves. For managing severe pain opioids like Percocet or oxycontin are given in limited doses. Take complete rest from work if you have pain. This would heal the compression gradually. Physiotherapy is effective to manage pain and regain muscle strength and flexibility. Steroid injections are given directly into the open space of the spine to relieve the extra pressure and to control inflammation. But this should not be made regular.

In rare cases surgery is done to get rid of extra pressure on the nerves of the spine. Laminectomy procedure is done to build spine strength in which the back part of the affected spine is removed. In Laminotomy the surgeon would create enough space on the central canal so that pressure cannot be exerted on the spine. Metals are used to bridge the gap of the opened sections in the spine. However there is no guarantee that symptoms of lower back pain will be reduced after spine surgery. It may remain the same or even get worse. For mild form of spinal stenosis over the counter anti-inflammatory agents like Advil or Motrin or Aleve can be taken. You can apply ice pack or hot water pack on the area. To maintain the posture while walking, you can use walkers for additional support.