Spinal Canal Stenosis
Learn more about common pain conditions, their development, and the pain mechanism.
Overview
Spinal canal stenosis is a condition characterized by the narrowing of the spinal canal, where the spinal cord is located. This narrowing can exert pressure on the spinal cord or the nerve roots branching from it, typically leading to back and/or limb pain, tingling, and numbness. In severe cases, muscle weakness in the legs can also occur.
Cause
The most common cause of lumbar spinal canal stenosis is degenerative changes due to spinal wear and tear. These include the flattening of intervertebral discs, thickening of ligaments, and the formation of bony growths. Approximately 11% of older adults experience symptoms of spinal canal stenosis.
Symptoms
Symptoms of lumbar spinal canal stenosis include back pain that can radiate to both legs, accompanied by numbness and tingling (sensory disturbances) in the lower legs and/or feet. The pain often worsens when standing or walking but can be relieved by sitting or leaning forward. The pain that occurs depending on walking distance is referred to as claudication spinalis. The condition typically progresses over time and can lead to a decreased quality of life.
Diagnosis
The diagnosis of symptomatic (symptom-causing) spinal canal stenosis is based on the symptoms, a medical examination, and imaging techniques. Imaging can sometimes also reveal spinal canal stenoses that are congenital and do not cause symptoms. These asymptomatic spinal canal stenoses do not require treatment.
Treatment
Treatment can include conservative measures such as lifestyle adjustments, walking training, physical therapy, targeted exercises, and medications. Besides basic painkillers, medications for nerve pain are often used. Additionally, epidural steroid injections near the spinal cord can be administered to alleviate symptoms. In some cases, surgery may be necessary to remove obstructive bone fragments, thickened ligaments, and disc tissue, thereby relieving pressure on the spinal cord and nerves. The decision for or against surgery should be made carefully, only after all non-surgical treatment options have been exhausted.
