Spinal stenosis is a widespread cause of back pain. In fact, an estimated 250,000 to 500,000 United States residents have spinal stenosis symptoms.

Patients suffering from back pain and other symptoms of spinal stenosis have several different treatment options to choose from. Here, we’ll dive into the details of spinal stenosis and how it’s treated to help you find the appropriate care for your needs.

What is Spinal Stenosis?

Spinal stenosis is a condition that occurs when the spaces within the spine narrow. As these spaces tighten, the spinal cord and the nerve roots that extend out from the intervertebral foramen may become compressed, pinched, and/or irritated.

While spinal stenosis can affect any region of the spine, it most commonly occurs in the lumbar spine (lower back) and the cervical spine (the neck). It’s also possible for spinal stenosis to occur in multiple areas of the spine.

What Causes Spinal Stenosis?

Some individuals have a narrow spinal canal due to genetic factors. However, most cases of spinal stenosis are caused by factors that trigger a tightening of the spinal canal.

Potential causes of spinal stenosis include:

• Herniated disc

A herniated disc occurs when a crack forms in the firm exterior of a spinal disc. The jelly-like interior may then push out through the crack and come into contact with the spinal cord or nearby nerves.

• Bone spurs

Bone spurs (AKA bone overgrowth) are lumps of extra bone tissue that can develop on the end of a bone. Often due to osteoarthritis, which involves the deterioration of the cartilage in your joints and spine, bone spurs can form on the vertebrae. The bone spurs can limit space in the spinal canal, leading to spinal stenosis.

Bone spurs and herniated disc are the two most prevalent causes of spinal stenosis. Although less common, the following factors can also trigger this spinal condition:

• Thickened spinal ligaments

The ligaments that connect the bones in the spine can, over time, become thicker and inflexible. As the ligaments thicken, they may extend into the spinal canal, limiting space and potentially pressing on nerves.

• Injury/trauma to the spine

A sudden trauma to the spine may fracture or dislocate one or multiple vertebrae. This type of injury may occur in a car accident, for example. If the spinal fracture leads to bone displacement, it may damage the tissues within the spinal canal and trigger spinal stenosis.

• Tumor inside of the spinal cord

Though unusual, tumors (abnormal masses) can develop on the interior of the spinal cord. These tumors, as well as spinal cord cysts, can limit space in the spinal canal and cause spinal stenosis. A CT scan or MRI is required to identify a tumor in the spinal cord.

Spinal Stenosis Symptoms

It’s worth noting that not all patients with spinal stenosis will experience symptoms. However, the symptoms of this condition can gradually develop and/or get worse over time.

Symptoms of lumbar spinal stenosis and cervical spinal stenosis can vary. Lumbar spinal stenosis symptoms include:

• Lower back pain (the pain may be achy, tender, burning, or sharp)
• Pain that worsens with prolonged periods of standing or walking downhill and subsides with bending forward, leaning, sitting, or walking uphill
• Tingling, numbness, and a “pins and needles” sensation in the buttocks, leg, or foot
• Sciatica, which is pain that radiates down the sciatic nerve, starting at the buttocks, moving down the leg, and potentially into the foot.
• Heaviness and/or cramping in the leg(s)
• In severe cases, lost bladder/bowel control

Cervical spinal stenosis symptoms include

• Neck pain
• Tingling, numbness, and a “pins and needles” sensation in the arm, hand, leg, or foot
• Weakness in the arm, hand, leg, or foot
• Balance issues
• Lost function in the hands (i.e. having trouble writing)
• In severe cases, lost bladder/bowel control

How is Spinal Stenosis Treated?

In many cases, spinal stenosis can be effectively treated without the need for surgery. However, if the patient doesn’t respond to non-surgical methods, surgery may be recommended to alleviate pain, weakness, sciatica, and other symptoms.

Non-Surgical Treatment for Spinal Stenosis

Patients can often achieve relief from symptoms of spinal stenosis with non-surgical treatments alone. The most common non-surgical methods for this condition include:

• Physical therapy, which generally combines therapeutic exercise and static therapies to relieve pain, reduce inflammation, improve flexibility, and build strength
• Chiropractic care, which focuses on improving spinal alignment to support your body’s healing process, ease inflammation, and alleviate symptoms
• Pain medications, while generally not considered a long-term solution, can help patients find relief from chronic back pain
• Steroid injections, which can provide relief from pain and inflammation, but should be used no more than 4 times per year
• Lifestyle modifications, such as rest, adjustments to physical activity, diet modifications, supplements, etc.

Surgical Treatment for Spinal Stenosis

Spinal decompression surgery can be performed to create more space in the spinal canal and relieve spinal stenosis symptoms. There are multiple types of surgical decompression, including:

• Laminectomy, which involves removing the entire lamina of the injured vertebra
• Laminotomy, which involves removing just part of the lamina for targeted pressure relief
• Laminoplasty, which is only done for cervical spinal stenosis and forms a door with the lamina to increase space in the spinal canal

Spinal Fusion

Patients undergoing decompression surgery are often recommended to have spinal fusion. Fusion prevents spinal instability after decompression by permanently connecting two vertebrae. Fusing the affected vertebrae eliminates motion between them, which lowers the patient’s risk of re-injury.

Alternatives to Spinal Fusion

Spinal stenosis treatment with fusion can limit the patient’s range of motion while requiring extensive back surgery recovery time. So, spinal fusion alternatives are becoming increasingly popular among modern patients. A non-fusion spine device can retain the flexibility of the spine while providing support in decompressive laminectomy.

Wrapping Up

Spinal stenosis is a common yet potentially debilitating condition. However, patients suffering from stenosis-related back pain have several treatment options at their disposal. Talk to your doctor about the available spinal stenosis treatments to determine the right method of care for your needs.