New York Spine Institute Spine Services

Signs and Symptoms of Spinal Stenosis

Signs and Symptoms of Spinal Stenosis

Signs and Symptoms of Spinal Stenosis

By: Angel Macagno, M.D. FAAOS

Dr. Angel Macagno was born and raised in Argentina where, as a board-certified physician, he practiced Orthopedic surgery for 15 years before deciding to fulfill his lifelong goal of practicing medicine in the United States.

Spine problems affect you more than you might expect. Simple things like standing to cook dinner or going downstairs require considerable effort to perform. While many spinal conditions cause such problems, you could be dealing with spinal stenosis. Learn the signs and symptoms of spinal stenosis below and what can be done for it. 

What Is Spinal Stenosis?

Spinal stenosis is a narrowing of your spinal canal — the space that houses your spinal cord. To understand spinal stenosis, you may benefit from a spine anatomy overview. First, your spinal column has 33 vertebrae bones stacked on top of each other, beginning at your skull base and ending at your pelvis. Each vertebra has a ring-shaped opening in itcs center, where the spinal canal passes through. Discs between each vertebra absorb shock and cushion the stack of vertebrae bones. 

The spinal cord — the highway connecting the brain with the rest of your body — runs through the spinal canal. The spinal cord is a nerve tissue column covered by three protective membrane layers. Nerve roots exit the spinal cord through spaces between each vertebra. Those spaces are called the neural foramen—the nerves exit through each opening and travel throughout your body. 

When spinal stenosis occurs, the narrowed spinal canal creates nerve and spinal cord pressure. The increased pressure can irritate, compress or pinch the spinal cord and nerves. Widespread issues in your spine and body may result. 

Types of Spinal Stenosis

Various spinal stenosis types exist, depending on the nerve compression and narrowing location. Spinal stenosis types involve two determining distinctions. The first distinction is whether it occurs in the cervical, thoracic or lumbar spine. The second distinction is if it happens in the vertebral foramen or neural foramen. Your vertebral foramen forms the spinal canal, while the neural foramen are bony openings between each vertebra. Your nerves exit the spinal cord through these bony openings. 

Here are the four main spinal stenosis types:

  1. Cervical stenosis: The spinal canal narrowing occurs around the vertebrae in your neck.
  2. Lumbar stenosis: The narrowing occurs in your lower spine. 
  3. Central canal stenosis: Cervical canal stenosis occurs when the vertebral foramen narrows. 
  4. Foraminal stenosis: Foraminal stenosis happens when the neural foramen narrows. This spinal stenosis type is also called lateral stenosis because the narrowing occurs to the spinal canal’s side. 

In some cases, foraminal stenosis and central canal stenosis may co-occur. Thoracic spinal stenosis — mid-spine narrowing — is also possible but rarely occurs. 

What Are the Symptoms of Spinal Stenosis?

Spinal stenosis symptoms vary with type and condition severity. They also depend on location. You can experience pain and dysfunction at any point in your body below the level of compression. If you have lumbar spinal stenosis, you may experience symptoms like the following:

  • Heaviness in your legs
  • Leg cramps
  • Lower back pain, which you may experience as dull, tender, electric or burning
  • Numbness or tingling in your buttocks, feet or legs
  • Pain that worsens when walking downhill or standing for a long time
  • Pain that lessens when you lean, bend slightly forward, walk uphill or sit down
  • Sciatica, or a pinched sciatic nerve, which travels from your lower back, through your hips and down each leg

As the stenosis worsens, you may experience leg or foot weakness, linking spinal stenosis with walking problems. In severe cases, you may experience bladder or bowel incontinence. Lumbar spinal stenosis rarely causes cauda equina syndrome, which involves compressed cauda equina nerves. This bundle of nerves, including the sciatic nerve, is beneath the spinal cord. Cauda equina syndrome is a rare surgical emergency since it can cause permanent paralysis of the legs.

With cervical spinal stenosis, you may experience such symptoms as:

  • Neck pain.
  • Numbness or tingling in your arm, hand, leg or foot. 
  • Arm, hand, leg or foot weakness or clumsiness.
  • Balance issues. 
  • Impaired hand function, which may affect activities like buttoning shirts or writing.
  • Bladder or bowel incontinence, in severe cases. 

Spinal stenosis symptoms occur gradually and intermittently. The symptoms are more often experienced as pain than neurological deficits like numbness, tingling or weakness. 

Causes and Risk Factors

Knowing spinal stenosis causes and risk factors helps prevent this condition. Let’s go through the spinal stenosis causes and risk factors below. 

Spinal Stenosis Causes

Various injuries and conditions can cause spinal stenosis, including general wear and tear. Some common spinal stenosis causes include:

  • Bone spurs: Bone spurs commonly result from osteoarthritis, which wears away joint cartilage, causing your bones to rub against each other. As your bones grind against each other, the damage stimulates osteoblast activity. Osteoblasts are cells that form new bone tissue. The new bone tissue created in these situations makes bone spurs. Spinal stenosis results when bone spurs occur on vertebrae and extend into the spinal canal.
  • Herniated discs: A herniated disc is when part of the cushioning disc between each vertebra bulges into the spinal canal. When the outer edge of spinal discs weakens or cracks, the gel-like center pushes through the edge from downward vertebral pressure.
  • Thickened ligaments: Your spinal ligaments hold each vertebra together. As ligaments experience stress and inflammation from general wear-and-tear, scar tissue forms. This scar tissue causes ligaments to thicken and lose flexibility. Thickened ligaments can pressure the spinal canal and cord, causing spinal stenosis.
  • Spinal fractures or trauma: Spinal fractures, inflammation or dislocations can narrow the spinal canal and create spinal cord pressure.
  • Spinal cord cysts or tumors: Benign or cancerous growths on the spinal cord or between it and the vertebrae can cause spinal stenosis. 
  • Congenital spinal stenosis: Individuals born with a small spinal canal receive a congenital spinal stenosis diagnosis. 

Spinal Stenosis Risk Factors

Some individuals are more at risk of spinal stenosis or conditions that cause it. Spinal stenosis risk factors include. Spinal stenosis risk factors include:

  • Osteoarthritis.
  • Age, particularly those over 50.
  • Spinal deformities, such as scoliosis.
  • Spinal injuries.

Treatment for Spinal Stenosis

Spinal stenosis treatment involves surgical and nonsurgical options. Doctors pursue nonsurgical options first, opting for surgery only in severe cases or when conservative approaches fail. Nonsurgical spinal stenosis treatment options include:

  • Physical therapy to increase flexibility and stability, build strength and endurance and improve balance.
  • Spinal decompression to increase spinal canal space and remove nerve impingement.
  • Steroid injections to reduce inflammation and relieve pain.
  • Over-the-counter (OTC) or prescription-grade pain relievers, such as ibuprofen, acetaminophen, antidepressants, anticonvulsants or opioids.

Spinal stenosis surgery options include:

  • Laminectomy: This surgery partially or fully removes your lamina, an arched vertebral section that forms the spinal canal walls. 
  • Spinal fusion: This surgery connects two or more vertebrae to increase spinal stability. Spinal fusion for spinal stenosis is rarely necessary. 

Seeking Treatment for Spinal Problems?

If any spinal stenosis signs or symptoms resonate with you, our skilled spine specialists at New York Spine Institute can successfully diagnose and treat your pain. For an appointment to treat your spinal problems, please feel welcome to contact us! We’ll promptly respond to your request with courteous service.