Spinal stenosis

This information may be useful for people who have been diagnosed with spinal stenosis. This includes cervical stenosis and lumbar stenosis. People who are experiencing new or ongoing symptoms should contact their healthcare professional.

Spinal stenosis is narrowing of the tunnels in the spine which contain the nerves or spinal cord. It’s a common condition. Most narrowing is a normal part of the ageing process and often does not cause problems.

In some cases spinal stenosis can lead to irritation or compression of the nerves. Spinal stenosis can affect any part of the spine but is most common in the lower back (lumbar stenosis) and neck (cervical stenosis). This can lead to pain in the lower back and legs, or in the neck, arms and hands.

Although stenosis can cause pain, the nerves can learn to adapt to the narrowed space. The majority of people with this condition can manage their symptoms well, with the right advice and information.

In some cases further help is necessary, particularly if symptoms are impacting your arm or leg function, walking or quality of life.

Symptoms of spinal stenosis can vary. Many people experience no symptoms at all. Though uncommon, some people can experience both lumbar and cervical stenosis at the same time.

Lumbar spine stenosis

Lumbar spine stenosis symptoms affect the legs and may include:

• pain
• aching
• cramping
• heaviness and or weakness
• tingling
• pins and needles
• numbness

These symptoms are usually worse with walking or standing, and are relieved by sitting or leaning forward.

Cervical spine stenosis

Cervical spine stenosis symptoms affect the arms and may include:

• pain
• stiffness
• weakness
• tingling
• pins and needles
• numbness

You may also experience headaches.

Patients with spinal stenosis can also have back or neck pain. However in the absence of leg or arm symptoms, low back or neck pain are usually not thought to be caused by stenosis.

Spinal stenosis is a long term condition, and symptoms can vary. Many patients find that managing their symptoms can help improve their quality of life.

Any progression of symptoms is usually slow. This allows time for symptoms to be monitored and for treatments to be considered.

Diagnosing spinal stenosis

Spinal stenosis can be diagnosed following an assessment from a healthcare professional. They will ask questions about your symptoms and carry out a physical examination.

In some cases, further examinations may be advised to rule out other serious health conditions. For people with severe and worsening symptoms, scans may be considered to help decide if spinal surgery may be helpful.

What causes spinal stenosis?

As we get older, ageing in the spine can cause tunnel narrowing and a reduction of space around the spinal cord or nerves. Other causes include:

• injury
• rheumatoid arthritis
• certain bone diseases
• being born with a narrow spinal canal

Often people experience no symptoms, but in some cases it can cause irritation of these tissues. However, the nerves can learn to cope with this narrower tunnel. It’s important to note that pain does not always mean the nerves are being damaged.

Pain can also be influenced by anything that impacts general health, such as poor sleep, stress and emotional wellbeing.

When to get professional help

Many people have a combination of pain, numbness and weakness affecting the low back and legs or neck and arms. These symptoms can be distressing, but don’t necessarily require urgent medical attention.

Occasionally spinal stenosis can lead to serious conditions called cauda equina syndrome or cervical myelopathy. These are rare, but serious spinal conditions which can lead to permanent damage or disability. Early recognition and treatment can prevent further deterioration. If you develop these conditions, you may need to be seen by an emergency specialist team

• hanges to bladder and bowel function e.g. urgency, frequency, difficulty passing urine, leaking, incontinence
• changes to sensation around the bottom and/or genitals or sexual dysfunction e.g. recent inability to achieve orgasm or erection
• reduced balance or difficulty walking
• pain, weakness, heaviness or changing sensation in the arms or legs
• clumsy hands e.g. dropping things, struggling with handwriting, buttons or zips
• if your neck pain is associated with a severe headache

Treatment for spinal stenosis

Many people can cope with their symptoms, as time can allow the nerves to adapt. Management options are based on a number of factors including individual’s symptoms, general health and patient preference.

Treatment options include:

exercise or physiotherapy

• exercise can reduce nerve irritation and make the nerve more resilient to movement. It will not change the spinal tunnel narrowing itself
• exercise may also help with general function, muscle strength and balance
• physiotherapy can also be beneficial, you may be referred to this or their may be an option to self-refer in your area.

lifestyle management including:

• staying active
• modifying activities and pacing techniques
• maintaining a healthy weight
• stopping smoking
• managing stress and emotional wellbeing

pain management strategies

• medication
• heat
• ice

As well as these treatments your healthcare professional may advise you to monitor any change of your symptoms symptoms.

Other treatment options

If symptoms are not improving and other treatments have been tried, other options include:

• spinal injections
• spinal surgery
• specialist pain services

Specific advice for treatment of lumbar stenosis

If you’ve been diagnosed with lumbar stenosis, although walking can be uncomfortable, it’s safe to continue walking as long as symptoms remain manageable. Walking short distances regularly is encouraged to help manage your symptoms.

If your leg symptoms are relieved by bending or leaning forward, it may be helpful to have regular breaks when walking. You can try taking a seat or leaning against a wall.

If you are struggling with walking, it may be helpful to talk to a healthcare professional about a walking aid.

Work

Problems linked to spinal stenosis can sometimes mean you need to take some time off work. This may depend on the nature of your symptoms and your role at work.

You do not need to be symptom-free before considering returning to work. Continuing to work or returning to work as soon as is possible will help your recovery. Gradually getting back to your normal daily activities can help to build up strength and stamina.