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Spinal stenosis is a medical condition characterized by compression of spinal canal, the cavity-like open space within the vertebrae column, at one or more places. The canal is the passageway for the spinal cord and its narrowing squeeze the spinal cord and pinch nerve roots in that particular area leading to neurological deficit and severe pain. Spinal stenosis mostly occurs in the lower neck or back. When it affects the lower back, patients experience pain in the back and leg as they walk down or climb a staircase. Osteoarthritis and inward bulging of facet joints on the vertebrae are considered primary reasons for the problem.

The spine has 33 individual bones known as vertebrae interlocked with each other. The spinal canal runs in the open space in the middle of the vertebrae column. The spinal cord, nerves, tissues and a number of other spinal components pass through this space. Spinal nerves connect the canal with outside elements through intervertebral foramen. When the spinal canal narrows down due to bony changes or stiffening of ligaments, the spinal cord and nerve roots are compressed and restricted. The pinching, thus leads to spinal stenosis reflected through pain, cramping, weakness or numbness in neck, shoulder, arm or leg.

Spinal stenosis symptoms take time to surface. But once these signs appear, patients feel worsening condition over time. Though symptoms vary according to the particular spinal area affected, there are certain common signs.

. Pain in neck, shoulder, arm or back depending the affected spinal area
. Radiating pain, from neck to arms, back to buttocks and thighs
. Cramping, numbness and weakness felt in arms or legs
. Back pain radiating to leg, knee, perineum and foot
. Cauda equine syndrome when the lower back spine is affected
. Pinched nerve syndrome
. Pain in limb movement
. Discomfort while standing or walking
. Bilateral symptoms
. Neurological disorder
. Radiculopathy
. Paresthesia
. Loss of motor control

Spinal stenosis may occur at any place along the length of the spine. It can occur in cervical, thoracic or lumbar spinal areas. Thoracic spinal stenosis is rare while the other two are more common. Cervical spinal stenosis is more dangerous and may result in serious complications, including quadriplegia, and choking of the spinal cord. Lumbar spinal stenosis may be associated with sciatica.

. Aging that causes degenerative changes in the spinal bone structure
. Bone spurs on facet joints protruding into the spinal canal
. Thickening of facet joint or spinal ligaments
. Herniated or bulging of disks into the spinal canal
. Damage to facet joints
. Spine fractures compressing the vertebrae column
. Osteoarthritis and rheumatoid arthritis
. Cysts in facet joints
. Spinal canal birth defects or congenital vertebrae deformities
. Unstable spine or slip disks
. Traumatic injury
. Tumors of the spine
. Tissue outgrowth in the spinal canal
. Recurring spondylitis
. Spinal tumors
. Calcium deposits in the spinal canal

Doctors use different methods to examine if the pain is due to spinal stenosis.

. Physical examination of symptoms and medical condition
. X-ray to investigate spinal injuries
. MRI test to check spinal and nerve conditions
. Bone scan using radioactive shots
. Detailed spinal analysis using computerized axial tomography
. Myelogram test or liquid dye injection into the spine

Self-Care and Conservative Treatment - Rest, physical therapy, acupuncture, flexibility exercises, limited physical activity and chiropractic treatment may provide limited relief at the early stage.

Medication and Medical Devices - Patients can use a brace to limit stress on the affected spinal area. NSAIDs, pain killers, analgesics and membrane stabilizing drugs are suggested to reduce swelling, inflammation and pain from spinal stenosis.

Surgery - Laminectomy, foraminotomy, Racz procedure and surgical decompression are a few surgical methods used to treat spinal stenosis. However, these procedures are opted for only when other options are exhausted without any relief.

Spinal cord stimulation - The therapy disrupts the pain perception and ensures relief. Studies indicate about 67 percent success in overcoming spinal stenosis pain with this therapy.

Facet joint injections - Numbing medication with or without steroid is administered to joints in the vertebra. It eases inflation, injury and bone spurs assuring relief and recovery. Studies show about 50 to 75 percent success rate with these injections when spinal stenosis is associated with facet joints.

Epidural steroid injection - Steroid injected into the epidural area treat nerve roots inflamed because of compression. Pain relief is about 80-90 percent when treated with these injections.