Spinal Stenosis

A Patients guide

Introduction

Spinal stenosis is a term used to describe a narrowing of the spinal canal that gives rise to symptoms of compression of the spinal nerves or sometimes the spinal cord. Narrowing that affects the spinal cord is also sometimes called a myelopathy. Spinal stenosis is quite a common problem particularly with older people, (however it can affect younger people but more rarely.)

The symptoms experienced are those of back pain and leg pain. Most typically it occurs as you walk a pain and will cause numbness or weakness or feelings of unsteadiness, sometimes in both legs sometimes in just one.

Claudication is the term used by doctors for weakness of the legs that gets worse specifically on walking.

Common causes are vascular due to narrowing of the blood vessels or spinal due to bone overgrowth causing a reduction in the space for spinal nerves.  

Classically the sufferer can walk a certain distance (sometimes 50m or further, say -500m) and then they need to stop because the pain & numbness intensifies. Most find that sitting down or leaning forward enables them to recover so that they can then walk again.  Some also get these symptoms on standing.

Spinal patients will sometimes find that cycling is an exercise they can do better than walking because of the position of leaning forward when cycling. Most doctors encourage exercise rather than rest.

Also usually patients have no pain in the leg at rest. (Back pain is not the same however and increased back pain on walking is not a feature of spinal stenosis.)

Causes

Usually as part of the natural aging process we develop degenerative change in the lower back.

Sometimes these changes lead to a partial constriction -or a "stenosis"- of the nerve tunnel within the spine which is called the central canal that is "central stenosis".

Others suffer a slightly different constriction to the smaller side tunnels with the spine which is called "foraminal stenosis".

Practically speaking the symptoms of each or these two types are essentially the same.

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