Spinal stenosis is a condition involving the narrowing of the spinal canal or its neural foramina (openings) at the sites where spinal nerves branch from the spinal column. This narrowing can cause a number of problems, such as pinched nerves, numbness, decreased mobility, and severe pain. Symptoms of a more advanced case may include loss of bladder control and poor balance while walking. Typically, symptoms are cumulative and become progressively worse over time.
Most often a degree of spinal stenosis occurs naturally via aging, as the spinal discs--the flexible shock absorbers that sit between the vertebrae--become drier, thinner, and less capable of bearing the stresses of movement. The ligaments and bones of the spine can also become swollen due to arthritis or other inflammatory conditions, consequently narrowing the spinal column and increasing the chance of pinched nerves. Also at risk for spinal stenosis are patients with Paget's disease, congenital birth defects that affect the growth of the spine (such as spina bifida), spinal tumors, and physical injury to the spinal column.
During a diagnostic physical exam, doctors may ask the patient to perform a series of exercises to learn how the patient's movement is affected by the condition. Sitting, walking, standing, walking on one's toes or heels--movements like these allow the doctor to assess what might be responsible for the patient's pain. Reflex tests may also be performed. Spinal X-rays, EMGs (electromyelograms), and MRIs (magnetic resonance imaging) can be used to confirm diagnosis.
Treatment options include physical therapy focusing on flexibility and core muscle strength to help remove stress from the narrowed spinal column. Heat pads, ice packs, pain relievers, and anti-inflammatory drugs can all be used to help reduce pain levels. If the spinal stenosis produces chronic pinched nerves and patients are at risk for permanent nerve damage, surgery may be advised. In such case, a foraminotomy, laminectomy, and spinal fusion have the potential to reduce chronic nerve pain.