Spinal stenosis

Spinal stenosis, also called spinal canal stenosis, is a condition caused by narrowing of the canal in which the spinal cord sits. The narrowing can put pressure on the nerves in the back, which can cause pain and weakness in the arms or legs.

Spinal stenosis most commonly occurs in the lower back (called a lumbar stenosis) and upper neck (called a cervical stenosis).

The symptoms depend on which part of the spine and nerves are affected. They can include:

• low back pain that radiates to the buttocks and legs
• leg pain with no back pain
• numbness, weakness or tingling in your hand, arm, foot or legproblems with walking
• neck pain or back pain, especially when walking or standing upright, and relived by sitting or leaning forward
• pain going down your arm or leg
• problems controlling your bowels or bladder

Symptoms may get worse over time.

Spinal stenosis is usually caused by age-related wear and tear, often from arthritis and most often after the age of 50. Some people are born with a narrowed spinal canal, which puts them at greater risk. Spinal stenosis can be caused by a disc prolapse (a 'slipped disc', a problem with the spongy discs between the bones of the spine).

Spinal stenosis can also be caused by a tumour or a back injury.

If you are experiencing any symptoms of spinal stenosis, make an appointment to see your doctor.

You should see your doctor if:

• your pain is getting worse over a few weeks
• you are in distress
• your ability to move is limited

When is back pain an emergency?

You should go to a hospital emergency department if you have back pain and you have:

• changes in your bladder and bowel movements, especially if you cannot pass urine
• changes in feeling around your bottom and inner thighs
• sudden significant weakness or numbness, or pins and needles in your legs
• a fever

To diagnose spinal stenosis your doctor, specialist or physiotherapist will ask questions about your symptoms and medical history and examine you. You may be referred for imaging tests to look at your spine, such as an x-ray, MRI or CT scan.

The results of an imaging scan do not always reflect the severity of your symptoms. You might not experience any symptoms, even if your scan shows spinal stenosis.

Treatment will depend on the severity of your symptoms and your general health.

Physiotherapy can help relieve pain. You may be shown strengthening and stretching exercises to do. Depending on where the stenosis is, your physiotherapist may recommend wearing a brace.

You might need to use a walking aid. Walking aids can help give you stability while walking and ease pain by assisting you to bend forward to walk.

Losing weight can also help reduce pain.

Medicines for spinal stenosis

Your doctor might recommend you take pain medicines to help reduce your pain enough so you can stay active. These might include:

• Over-the-counter pain relief medicines such as paracetamol
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to treat inflammation and pain
• Prescription pain relief such as opioids for more severe pain.

Your doctor may recommend an injection of local anaesthetic or a corticosteroid into your back.

Surgery

If your symptoms are getting worse, or if other treatments don't work, your doctor may recommend surgery. A laminectomy surgery involves removing part of the vertebra (spinal bone) to create more space and take pressure off the nerves. Sometimes surgery also involves fusion (joining 2 bones together) to make them more stable.

Most people are advised to try other treatments first before resorting to surgery.

Visit the pages to learn more about surgical procedures:

• Preparing for surgery
• How to find the right health professional

Living with spinal stenosis can cause loss of strength and muscle weakness over time that affects balance, walking and ability to do normal activities. These can lead to social isolation and may affect your mental health and wellbeing.

Other complications from spinal stenosis include:

• loss of bowel or bladder control
• sexual dysfunction such as erectile dysfunction
• partial leg paralysis

These complications are caused by nerve compression in the spine. If you have ongoing neck or back pain or any of the complications noted above, you should see a doctor for advice and treatment.

As spinal stenosis is mostly caused by age and wear and tear it can't always be prevented, but there are things you can do to keep your spine healthy and reduce your risk of developing problems with your spine.

These include:

• Being physically active and exercising regularly to maintain strong muscles
• Maintaining a healthy weight. Excess weight puts an extra load on your spine.
• Eat a healthy diet, including foods that contain calcium for health bones
• Quitting smoking
• Practicing good posture

More information about laminectomy can be found at the Neurosurgical Society of Australasia (Opens in new tab).

Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.