Back aches and pains are a
health concern for millions of people. Nearly 12 million Americans
annually see their doctors because of back aches and pains. There may be
many reasons for backaches and pains. One cause could be spinal stenosis.
Stenosis means narrowing. In
spinal stenosis, the spinal canal, which contains and protects the
spinal cord and nerve roots, narrows and pinches the spinal cord and
nerves. The result is low back pain as well as pain in the legs.
Stenosis may pinch the nerves that control muscle power and sensation in
Causes of spinal stenosis
There are many potential
causes for spinal stenosis, including:
Aging. As you get older,
the ligaments (tough connective tissues between the bones in the
spine) can thicken. Spurs (small growths) may develop on the bones
and into the spinal canal. The cushioning disks between the
vertebrae may begin to deteriorate. The facet joints (flat surfaces
on each vertebra that form the spinal column) also may begin to
Heredity. If the spinal
canal is too small at birth, symptoms may show up in a relatively
Changes in blood flow to
the lumbar spine.
Symptoms of spinal
Pain and difficulty when
walking, aggravated by activity.
Numbness, tingling, hot
or cold feelings, weakness or a heavy and tired feeling in the legs.
falling, or a foot-slapping gait.
Diagnosing spinal stenosis
These symptoms also can be
caused by many other conditions, which makes spinal stenosis difficult
to diagnose. There is usually no history of back problems or any recent
injury. Often, unusual leg symptoms are a clue to the presence of spinal
If simple treatments, such as
postural changes or nonsteroidal anti-inflammatory drugs, do not relieve
the problem, your orthopaedic surgeon may request special imaging
studies to determine the cause of the problem. An MRI (magnetic
resonance image) or CAT (computed tomography) scan may be requested. A
myelogram (an X-ray taken after a special fluid is injected into the
spine) may be arranged. These and other imaging studies provide details
about the bones and tissues and assist the orthopaedic evaluation.
Changes in posture.
People with spinal stenosis may find that flexing the spine by
leaning forward while walking relieves their symptoms. Lying with
the knees drawn up to the chest also can offer some relief. These
positions enlarge the space available to the nerves and may make it
easier for stenosis sufferers to walk longer distances.
the pressure on the nerves is caused by inflammatory swelling.
Nonsteroidal anti-inflammatory medication such as aspirin or
ibuprofen may help relieve symptoms.
Rest, followed by a
gradual resumption of activity, also can help. Aerobic activity such
as bicycling is often recommended.
Losing weight can also
relieve some of the load on the spine.
When stenosis causes severe
nerve root compression, these treatments may not be enough. Back and leg
pain may return again and again. Because many stenosis sufferers are
unable to walk even short distances, they often confine their activities
to the home.
If conservative treatment
does not relieve the pain, your orthopaedic surgeon may recommend
surgery to relieve the pressure on affected nerves. In properly selected
cases, the results are quite satisfactory, and patients are able to
resume a normal lifestyle.
Source: AAOS Research Dept. patient visits for selected conditions,