In a normal healthy spine, bundles of nerves exit the spinal column at dozens of tiny locations from the base of the skull to the top of the lower back. When these openings become blocked or narrowed, nerves can become impinged, leading to a condition called spinal stenosis.
The vast majority of cases of spinal stenosis occur in the lower back. Lumbar spinal stenosis can severely restrict daily activity. Because lumbar stenosis almost always impinges the sciatic nerve, one or both of the legs can also be affected. Radiating pain or numbness in the legs, and sometimes the ankles, feet and toes, is common.
What causes changes in these openings? A lot of things. One major cause is the process of aging. As joints and ligaments undergo wear and tear, they can shift partially into these spaces. In fact, stenosis is most common in people in their 50s and beyond.
Stenosis also has can be inherited or acquired at birth. In rare cases, synovial cysts, which develop as a result of degeneration in the facet joint in the lumbar spine, have been linked to spinal stenosis, or at least mimic many of the symptoms of spinal stenosis.
Symptoms of spinal stenosis include:
- Burning, tingling, or shooting pain in the buttocks or extremities
- Diminished pain in the extremities when bending forward or sitting (which relieves the pressure on the nerve by temporarily opening the vertebral space)
Cervical stenosis with myelopathy is a type of stenosis that affects the long tracts of nerves inside the spinal cord.
Symptoms of myelopathy include:
- Arm pain
- Heavy feeling in the legs
- Inability to walk at a fast pace
- Loss of fine motor skills
- Shooting arm and leg pain, particularly when bending the head forward
Rest and restricted activity, as well as over-the-counter medications, such as aspirin and analgesics, and corticosteroid injections, have been known to provide only temporary relief of the pain associated with stenosis. Physical therapy and back braces have also shown to be somewhat effective.