What Is Spinal Stenosis?

It's when the spaces around your spinal column get narrow. This can put pressure on those bones (vertebrae) and on your spinal cord, affecting the nerves that run from your spine to your arms and legs. It happens most often in your lower back or neck. The narrowing can be congenital or due to secondary problems like arthritis or disc herniation. 

You may not notice any. But if the narrowing puts pressure on your spinal cord or nerve roots, you may have numbness, weakness, cramping, and pain in your arms and legs. In more severe cases, you may have trouble with your bowel, bladder, or having sex.

It’s most common in men and women over 50 years old. But it can happen when you’re younger if you’re born with a condition that narrows your spinal canal, or you injured your spine in some way.

The ligaments (cords that hold your spine together) may get thicker and harder as you age. Bones and joints also may get bigger, and that can narrow the spaces between your vertebrae. Arthritis, which is more common when you’re older, can make this worse.

Several things can put pressure on your spinal cord and nerves. For example, if you have a herniated disk, the soft cushions or “disks” that separate your vertebrae can crack and ooze. Tumors also can grow in the spine, or a sudden injury can shift your spine or create bone fragments there.

Your doctor will ask about your medical history because injuries and other health problems may cause the same symptoms. They’ll check for pain when you bend backward and test your muscle strength and reflexes. They also may want do imaging scans to look inside your spinal column and check for things like tumors, bone spurs, or an injury. 

In addition to your regular doctor, you also may see physical and occupational therapists (who help you with certain exercises), a rheumatologist (who treats arthritis and related disorders), and a neurologist (who treats nerve problems). If you need surgery, you’d probably see an orthopedic surgeon (who deals with bones) or a neurosurgeon (who focuses on your nervous system).

To treat inflammation and pain, your doctor may suggest that you take over-the-counter drugs like acetaminophen, aspirin, naproxen, or ibuprofen. If those don’t help, they may give you a shot of a steroid (such as cortisone) in your spinal cord to ease inflammation and pain. Another option is an anesthetic medication to block pain near the affected nerve. 

Your doctor might recommend that you not do some activities. They also might suggest certain exercises to strengthen your stomach and back muscles to help support your spine. Aerobic exercises -- swimming, biking, or brisk walking -- can be good ways to stay active. If you’re older or have weak stomach muscles, you might need a brace to strengthen your backbone.

A lot depends on your overall health and how much your symptoms affect your day-to-day life. If you’re in good shape but have numbness or weakness that makes it hard to walk or causes bladder or bowel problems, your doctor may suggest surgery. It's a big step, so it’s important to weigh your options.

The goal is to relieve pressure on your spinal cord and nerves and support your spine. Your surgeon may adjust, trim, or take out the parts of your spinal column that are causing the pressure. They may also join together (fuse) some of your vertebrae in the problem section.

Most people have less pain and are able to walk better after surgery. But, as with many operations, infection and blood clots are possible. You also could have a tear in the membrane that covers the spinal cord. All of these are treatable, but they may make your recovery time longer.