Spinal stenosis
The canal the nerves run through narrows with age. The legs give trouble on walking and ease on sitting or leaning forward. This condition usually moves slowly.
What is spinal stenosis?
The spinal cord and nerves run in a canal inside the spine. With age, discs become drier and bulge, and bone and ligaments thicken. These changes narrow the canal or the openings where nerves leave it. Some people are also born with a narrower canal.
Signs
Symptoms usually get worse slowly:
- Pain, cramping or numbness in the back, buttocks, thighs or calves
- Weakness in part of a leg
- Worse with standing and walking
- Better with sitting or leaning forward
Most patients cannot walk for long without significant pain. Stenosis also occurs in the neck, where the signs are in the shoulders and arms.
Tests
The doctor checks your walking, bending, strength, feeling and reflexes. An MRI or CT, an X-ray and sometimes a nerve conduction study complete the examination.
Treatment without surgery
- Physiotherapy and strengthening of the back muscles
- Pain relief as your doctor advises
- Cold and heat packs on painful days
- An epidural injection around the nerves in some patients
Many patients stay active with some changes in activity and work.
When does surgery come up?
When pain does not improve with these treatments, daily life and work are disrupted, or feeling and movement are lost. You and your surgeon decide together, and it is not usually urgent unless a sign from the list below appears.
The most common operation in the low back is a laminectomy: part of the bone at the back of the canal is removed so the nerves have room. Sometimes the bones are also fixed by fusion.
What to expect from surgery
Surgery often eases leg symptoms partly or fully, but it is hard to predict how much. Someone with years of back pain is likely to have some pain afterward. Nerve damage from long pressure sometimes does not fully recover, even once the pressure is removed.
Risks include infection, bleeding, blood clots, nerve injury, a spinal fluid leak and the return of pain.
When to report early
- Walking becomes difficult, or balance is poor
- Leg numbness or weakness gets worse
- Controlling urine or stools becomes a problem
The last one is an emergency. See the full list of signs.
Frequently asked questions
Why am I more comfortable leaning on a shopping trolley?
Leaning forward opens up a little more room for the nerves, so sitting or leaning forward eases the pain.
Will spinal stenosis paralyse me?
Most patients stay active with some changes in work and activity, and the condition moves slowly. But report worsening weakness, poor balance or trouble controlling urine or stools early.
Bring your images. We read them together.
Go to the booking page or talk to support. Bring the CD or film of your MRI and CT with you.