Learn About Spinal Stenosis
Spinal stenosis is narrowing of the spinal column that causes pressure on the spinal cord, or narrowing of the openings (called neural foramina) where spinal nerves leave the spinal column.
Pseudo-claudication; Central spinal stenosis; Foraminal spinal stenosis; Degenerative spine disease; Back pain - spinal stenosis; Low back pain - stenosis; LBP - stenosis
Spinal stenosis usually occurs as a person ages, however, some people are born with less space for their spinal cord.
- The spinal disks become drier and start to bulge and can rupture.
- The bones and ligaments of the spine thicken or grow larger. This is caused by arthritis or long-term swelling.
Spinal stenosis may also be caused by:
- Arthritis of the spine, usually in middle-aged or older people
- Bone diseases, such as Paget disease
- Defect or growth in the spine that was present from birth
- Narrow spinal canal that the person was born with
- Herniated or slipped disk, which often may have happened in the past
- Injury that causes pressure on the nerve roots or the spinal cord
- Tumors in the spine
- Fracture or injury of a spinal bone
Symptoms often get worse slowly over time. Most often, symptoms will be on one side of the body, but may involve both legs.
Symptoms include:
- Numbness, cramping, or pain in the back, buttocks, thighs, or calves, or in the neck, shoulders, or arms
- Weakness of part of a leg or arm
Symptoms are more likely to be present or get worse when you stand or walk. They often lessen or disappear when you sit down or lean forward. Most people with spinal stenosis cannot walk for a long period without having significant pain.
More serious symptoms include:
- Difficulty or poor balance when walking
- Problems controlling urine or bowel movements
Your provider and other health professionals will help you manage your pain and keep you as active as possible.
- Your provider may refer you for physical therapy. The physical therapist will teach you stretches and exercises that make your back muscles stronger.
- You may also see a chiropractor, a massage therapist, and someone who performs acupuncture. Sometimes, a few visits will help your back or neck pain.
- Cold packs and heat therapy may help your pain during flare-ups.
Treatments for back pain caused by spinal stenosis include:
- Medicines to help relieve back pain.
- A type of talk therapy called cognitive behavioral therapy to help you better understand your pain and teach you how to manage back pain.
- An epidural spinal injection which involves injecting medicine directly into the space around your spinal nerves or spinal cord.
Spinal stenosis symptoms often become worse over time, but this may happen slowly. If the pain does not respond to these treatments, or you lose movement or feeling, you may need surgery.
- Surgery is done to relieve pressure on the nerves or spinal cord.
- You and your provider can decide when you need to have surgery for these symptoms.
Surgery may include removing a bulging disk, removing part of the vertebra bone, or widening the canal and openings where your spinal nerves are located.
During some spinal surgeries, the surgeon will remove some bone to create more room for your spinal nerves or spinal column. The surgeon will then fuse some of the spine bones to make your spine more stable. But this will make your back more stiff and may cause arthritis in areas above or below your fused spine.
Summit Orthopedics
David Strothman, M.D., is a spine surgeon at Summit Orthopedics, serving Minneapolis/St. Paul metro patients. He specializes in minimally invasive spine surgery; cervical, thoracic, and lumbar spine conditions; and adult scoliosis. Dr. Strothman is a frequent recipient of Mpls.St.Paul Magazine’s Top Doctor and Rising Star awards. He completed a fellowship in orthopedic spine at Twin Cities Spine Center. “Spinal disorders are complex and disabling,” explains Dr. Strothman. “As your surgeon, I will explain your diagnosis and treatment options, both operative and nonoperative, in a way that you can understand thereby allowing you to make informed decisions. I am rewarded daily by improving the quality of life of patients receiving my care.”. Dr. Strothman is rated as a Distinguished provider by MediFind in the treatment of Spinal Stenosis. His top areas of expertise are Spinal Stenosis, Spondylolisthesis, Herniated Disk, Laminectomy, and Microdiscectomy.
Proliance Surgeons
John M. Blair, MD, is a board-certified orthopedic spine surgeon with a specialty in the treatment of degenerative conditions of the cervical and lumbar spine. His professional interests focus on outpatient minimally invasive spinal surgery resulting in the least possible amount of down time, early return to work and active lifestyles for his patients. He treats a wide range of spinal conditions with expertise in deformative spinal conditions, such as scoliosis, and major reconstructive spine surgery. Dr. Blair believes that his role as a physician is to understand each patient’s individual needs and personalize treatment. A practicing surgeon since 1994, he has over 20 years of experience in all aspects of spinal surgery. He is also constantly learning new and innovative skills to better serve his patients. He gives community lectures on new innovations in spinal care and is an active member of the Puget Sound Spine Interest Group, a local group that meets quarterly with guest speakers. He is also a member of an annual medical mission group. He and his wife have six children. In addition to family time, he enjoys computers, photography, and outdoor activities. He is an Eagle Scout and currently helps out with his son’s local Boy Scouts troop. Dr. Blair is rated as a Distinguished provider by MediFind in the treatment of Spinal Stenosis. His top areas of expertise are Spinal Stenosis, Spondylolisthesis, Fractured Spine, Laminectomy, and Microdiscectomy.
Summit Orthopedics
Edward Santos, M.D., is a spine surgeon at Summit Orthopedics, serving Minneapolis/St. Paul metro patients. He completed four fellowships: Adult Orthopaedic Reconstruction at the University of Minnesota, Spine Surgery at Twin Cities Spine Center, Revision Joint Surgery and Transplantation in Australia, and Spine Surgery in Australia. As an associate professor at the University of Minnesota, he educated medical residents for over a decade. He is a frequent Top Doctor recipient from Mpls.St.Paul Magazine. He says, “I want to be the doctor with whom patients can share their fears and concerns and dreams. And when they tell me I’ve changed their life and given them back their life? Without a doubt, that’s the best part of my job.". Dr. Santos is rated as a Distinguished provider by MediFind in the treatment of Spinal Stenosis. His top areas of expertise are Spinal Stenosis, Spondylolisthesis, Invertebral Disc Disease, Herniated Disc Surgery, and Cervical Disc Surgery.
Many people with spinal stenosis are able to be active with the condition, although they may need to make some changes in their activities or work.
Spine surgery will often partly or fully relieve symptoms in your legs or arms. It is hard to predict if you will improve and how much relief surgery will provide.
- People who had long-term back pain before their surgery are likely to have some pain after surgery.
- If you needed more than one type of back surgery, you may be more likely to have future problems.
- The area of the spinal column above and below a spinal fusion is more likely to be stressed and have problems and accelerated arthritis in the future. This may lead to more surgeries later.
In rare cases, injuries caused by pressure on the nerves are permanent, even if the pressure is relieved.
Contact your provider if you have symptoms of spinal stenosis.
More serious symptoms that need prompt attention include:
- Difficulty or poor balance when walking
- Worsening numbness and weakness of your limb
- Problems controlling urine or bowel movements
- Problems urinating or having a bowel movement
Summary: This prospective longitudinal study will compare incidence rates of Medicare beneficiary surgical and minimally invasive intervention post index procedure, as well as harms associated with the MILD procedure, at 24 months post-treatment with MILD, tested against a control group of similar patients that have had a comparable procedure. This study will start with patients treated with a study proced...
Summary: This is a prospective, randomized controlled trial of patients undergoing minimally invasive transforaminal lumbar interbody fusion. This study will randomize patients into one of two groups: erector spinae plane (ESP) block and no ESP block.
Published Date: August 27, 2024
Published By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Bussières A, Cancelliere C, Ammendolia C, et al. Non-surgical interventions for lumbar spinal stenosis leading to neurogenic claudication: a clinical practice guideline. J Pain. 2021;22(9):1015-1039 PMID: 3385761 pubmed.ncbi.nlm.nih.gov/33857615/.
Gardocki RJ, Park AL. Degenerative disorders of the thoracic and lumbar spine. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 39.
Issac Z, Sarno D. Lumbar spinal stenosis. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 50.
Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and management of lumbar spinal stenosis: a review. JAMA. 2022;327(17):1688-1699 PMID: 35503342 pubmed.ncbi.nlm.nih.gov/35503342/.