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Spinal Stenosis

Introduction

Spinal stenosis is an abnormal narrowing (stenosis) of the spinal canal that may occur in any of the regions of the spine.

Anatomy

When stenosis occurs in the lower back, it is called lumbar spinal stenosis.  It often results from the normal aging process.  As people age, the soft tissues and bones in the spine may harden or become overgrown.  These degenerative changes may narrow the space around the spinal cord and result in spinal stenosis.

Causes

Spinal stenosis is most frequently caused by the gradual degeneration of the spine.  The spine can break down because of the natural aging process, arthritis, or certain spine conditions.  Also with age, the discs become less fluid-filled and dry out.  The discs can lose height and bulge into the spinal canal.  The spinal facet joints and ligaments can thicken and enlarge, pushing into the spinal canal.  Such structural changes can cause the spinal canal to narrow, causing painful pressure on the spinal cord or spinal nerves.

Symptoms

Spinal stenosis may or may not produce symptoms, and many people do not have any pain.  Common symptoms include back, buttock, and leg pain that tends to get worse over time and with activity.  You may also experience leg heaviness, numbness, weakness, or cramping.  Prolonged standing or walking may increase your symptoms.  Bending forward or sitting may relieve symptoms because these positions increase the room in the spinal canal, taking pressure off the spinal cord.

Diagnosis

Your doctor can diagnose spinal stenosis by performing a physical examination and ordering diagnostic tests.  You will be asked to perform simple movements to help your doctor assess your muscle strength, joint motion, and spine stability.  Imaging studies will be ordered to learn more about the location and extent of your spinal canal narrowing and nerve root compression.

Treatment

The majority of people with spinal stenosis can be treated with non-surgical methods aimed at pain management.  Your doctor may order physical therapy to help you strengthen you back, stomach, and legs.  People with weak stomach muscles or spinal degeneration may wear a lumbar brace during activities to provide support.  Stretching exercises will help to keep your back flexible.  Your therapist can also recommend durable medical equipment to aid your safety and activity performance.  Such devices could include a cane for walking or a shower chair.

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