What is spinal stenosis ?
Spinal stenosis is a condition where the space for neural elements in spinal column is narrowed. This leads to narrowing of channels where spinal cord and nerve roots travel resulting in compression of the neural elements.
What is the causes of spinal stenosis ?
- Primary / Developmental spinal stenosis- which means you’ve had it since birth although the symptoms appear in later part of the life. This is a form of inherited stenosis called short pedicle syndrome. These patients are more prone to develop symptoms in midlife. Primary spinal stenosis isn’t common.
- The second category is the commonest and happens due to wear and tear or degeneration process . This results from degenerative changes in the ligaments of the canal or due to some disease or injury to the spine. The most common direct cause of spinal stenosis is osteoarthritis of spine coupled with degenerative changes in the disc and facet joints.
- Aging : as a part of the normal age related degenerative process.
- Life style : Stress and emotional tension, poor posture -standing for long periods of time or sitting incorrectly—can cause spinal stenosis , heavy physical work, lifting or forceful movement, bending, or awkward positions can really hurt your back.
- Injuries and Accidents : Injury to muscle , ligaments , or soft tissue can lead to spinal stenosis .Fracture in spinal bone in a fall or a car accident also is a common cause
- Obesity : Being overweight puts pressure and stress on the back, especially the low back. Carrying excess weight aggravates other health conditions such as osteoporosis (weak bones), osteoarthritis (joint pain), rheumatoid arthritis (an autoimmune disease), degenerative disc disease (described above in the aging section), spinal stenosis, and spondylolisthesis.
Specific conditions can present with secondary stenosis
- Large Slip disc.
- Facetal arthritis.
- Primary spinal tumours,
- Spinal Metastatic tumours,
- Spinal Fracture
What are the symptoms are spinal canal stenosis ?
This depends on the level at which the stenosis is in the spine. Lower spine (lumbar) stenosis can present as –
- Neurogenic claudication – Pain or cramping in legs during standing stand for long periods of time or when you walk. The discomfort usually eases if you bend forward or sit down, but comes back when you stand upright. Symptoms which appear on walking and subside when you bend forward is typical of lumbar spinal stenosis. This type of pain is called neurogenic claudication. Patients with this condition may find walking uphill or climbing stairs more comfortable than walking straight.
- Increased frequency of urination or
- Urgency of urination
- Inability to control urine.
Depending on the location the spinal stenosis has been classified into cervical spinal stenosis or lumbar canal stenosis
Cervical Spinal Stenosis:
- Spinal stenosis in neck (cervical spine) can cause.
- Neck pain.
- Shoulders pain.
- Vertigo, giddiness.
- Arm pain.
- Pain in nape of neck.
- Forearm pain.
- Difficulty in walking.
- Imbalance during walking.
- Numbness in hands.
- Difficulty in finer functions of hand such as holding a glass, change of signature etc.
- Numbness, or muscle weakness.
- Loss of balance, which can lead to clumsiness or a tendency to fall.