Spinal Canal Stenosis

What is it?

Spinal canal stenosis is a term used to describe a narrowing of the spinal canal that causes symptoms of compression of the spinal nerves or sometimes the spinal cord. 

It can affect any part of the spine but is more common in the neck and lower back.  The narrowing is most often due to degenerative changes (arthritis) but can also be caused by a herniated (slipped) disc, spondylolisthesis or even a lesion in the canal itself.  

What are the symptoms?

Not all patients with spinal stenosis are  symptomatic.  Those with lumbar stenosis may complain of back pain and leg pain. Typically it occurs with prolonged walking or standing and will cause numbness,  weakness or feelings of unsteadiness, usually in both legs, but sometimes in just one.  Sitting or bending forwards will often alleviate these symptoms.

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Spinal canal stenosis in the neck may cause arm pain, numbness, weakness, loss of dexterity (e.g. difficulty doing up shirt buttons and shoe laces), bladder problems and poor balance or coordination.  This is known as cervical myelopathy and will need a specialist review.

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In general, such symptoms tend to gradually deteriorate.

Treatments

Treatment options for spinal stenosis include exercise (a static bike may be better tolerated than walking), activity modification, weight loss where applicable, physical therapy to maintain good core strength and medication to help the pain.   Steroid injections by way of a caudal epidural injection may be beneficial but is seldom a cure. If these methods are not effective, surgery may be needed to eliminate pressure on the nerves.