6 Signs of Spinal Stenosis

Article feature on Spine-Health

Does your back, arm, or leg pain seem to come and go, depending on what you’re doing at the moment? This sign may indicate spinal stenosis.

Spinal stenosis happens when the bony openings for your spinal nerves (foramen) and/or the spinal cord (central canal) become narrow. This narrowing may compress your spinal cord and/or spinal nerves and can develop at various points along your spine. Spinal stenosis is a condition that’s more likely to occur in people over 60 years of age and tends to worsen as the years add up.

Here are 6 typical signs and symptoms to watch out for if you suspect your pain is from spinal stenosis. Depending on the type and location of the stenosis, one or more symptoms may be experienced:

1. Neurogenic claudication

When the nerves in your lower back get compressed, you may experience neurogenic claudication in your legs. Neurogenic claudication usually has the following characteristics:

  • Constant pain and/or numbness in your legs while standing
  • Increased pain and/or numbness in your legs while walking variable distances and/or while bending the spine backward
  • Difficulty in performing upright exercises or activities
  • Improvement or resolution of pain and/or numbness with rest

Neurogenic claudication pain is typically relieved when you bend your spine forward (such as while leaning on a shopping cart/walker, squatting, or sitting and leaning forward).

Your doctor will likely need to differentiate this pain from vascular claudication, which can mimic neurogenic claudication.

2. Sciatica

Compression of the nerve roots in your lower back may lead to lumbar radiculopathy or sciatica (depending on the nerve roots affected). Sciatica is experienced as nerve pain and weakness typically felt in one leg at a time.

Depending on the nerve root(s) affected, pain may occur in your lower back, buttock, thigh, calf, leg, and/or foot. A pins-and-needles sensation, tingling, weakness, and/or numbness may also occur in the areas affected by pain.

3. Foot drop

Compression of the L4 and L5 nerve roots in the lower spine may cause motor weakness in your foot, resulting in foot drop. This condition typically causes a feeling of weakness while attempting to lift the foot and/or toes upward. As a result, the individual may involuntarily drag their foot or tend to trip while attempting to walk.

The compression of the S1 nerve root may cause weakness while walking on tip-toes.

4. Gait problems

Spinal stenosis can affect walking in different ways depending on its location within the spine, for example:

  • Lumbar spinal stenosis (in the lower back) may cause gait problems due to foot drop. The condition may also cause weakness in thigh and leg muscles, such as the quadriceps and the calves.
  • Cervical spinal stenosis (in the neck) with spinal cord compression may cause difficulty in maintaining balance while walking, especially in the dark. However, cervical spine stenosis with a pinched nerve does not cause gait imbalance.

Changes in gait may be too subtle to notice at first. Over time, the condition may present with progressively increasing falls.

5. Radiating arm pain

Cervical spinal stenosis may cause mild to moderate burning or shock-like pain in the neck, shoulder, and/or arms. Abnormal sensations, such as tingling, crawling, and/or numbness may be felt in both hands. The arms and hands may feel weak.

6. Loss of fine motor skills

Spinal stenosis in the cervical spine may cause difficulty in doing tasks that involve fine motor skills of the hand, such as buttoning a shirt. In the advanced stages, there may be difficulty with writing, eventually making holding a pen impossible.

If these symptoms sound familiar, check with your doctor, since spinal stenosis may get worse without treatment.

Red-flag signs and symptoms of spinal stenosis

Rarely, severe spinal stenosis may cause red-flag symptoms, such as bowel and/or bladder incontinence, numbness in the inner thighs and genital area, and/or severe weakness in both legs.

These symptoms indicate a serious medical condition, such as cauda equina syndrome, which must be treated urgently to prevent permanent loss of function in the legs.

An accurate diagnosis by a medical professional is necessary to determine the underlying cause of spinal stenosis. Depending on the cause and severity, your doctor may suggest nonsurgical treatments, such as physical therapy, pain-relieving medications, and/or activity modification. Sometimes, minimally invasive procedures, such as epidural steroid injections may be advised. Surgery is rarely advocated as the first-line treatment unless there are severe symptoms or neurologic deficits.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Symptoms & Solutions: Spinal Stenosis

Article featured on Arkansas Surgical Hospital

What is Spinal Stenosis?

Spinal stenosis is a deterioration of vertebrae that causes narrowing of the openings of the spinal column.  Over time, this puts pressure on the nerves inside the spinal column.  In most cases, individuals develop spinal stenosis in either the neck (called cervical stenosis) or the lower back (called lumbar stenosis).

What Causes Spinal Stenosis?

The most common cause of spinal stenosis is osteoarthritis that causes bone spurs.  These spurs can impinge on the spinal cord or pinch one or more nerves emanating from the spinal column.  Other causes of spinal stenosis include pressure on the spinal cord or nerves from herniated discs, tumors, thickened or inflamed ligaments, or trauma that dislocates or breaks vertebrae.

Types of Spinal Stenosis & Their Symptoms

Some people develop mild cases of spinal stenosis without experiencing any symptoms.  However, if the deterioration continues over time, a variety of symptoms can develop.  Symptoms are most common in individuals over 60 years of age and tend to become more severe with age due to wear and tear on the spinal vertebrae. Symptoms typically vary based on the location of the stenosis in the spine.

Lumbar Spinal Stenosis

Spinal stenosis is more common in the lower back than in the neck.  This type of spinal stenosis is called lumbar stenosis.  The most common symptom of lumbar stenosis is neurogenic claudication, which is leg pain that comes and goes due to pinched nerves in the spinal cord.  It can cause weakness or cramps in the legs that can be severe.  It is more troublesome when standing or walking for long periods, and it may become less severe or go away when you sit or bend forward.

Numbness or a pins-and-needles sensation in one or both legs is another symptom.  The sensation is similar to when your foot falls asleep, but is more frequent or may last longer.  Weakness in the feet or legs can also indicate lumbar stenosis.  Gait issues such as foot drop may arise from weakness in the calves or quadriceps.  Foot drop is the inability to raise the front of the foot properly due to weakness.  Instead, the foot drops forward, often dragging on the ground or causing the person to trip.

When the pain is in one leg and accompanied by weakness, it may be referred to as sciatica, depending on which nerve is compressed.  Some individuals may feel pain in the buttocks and lower back as well.

Cervical Spinal Stenosis

The narrowing of the spinal column that causes pressure on the spinal cord in the neck is called cervical stenosis.  People with cervical stenosis can develop problems with their gait and keeping their balance, which affects their mobility.  The gait problems arise from the compression of the spinal cord rather than a pinched nerve.  This condition progresses over time, with the individual falling more frequently as the compression worsens.

Pain in the shoulder, arm, or neck may also be a sign of cervical stenosis, particularly if the pain is shock-like or is accompanied by a burning sensation.  Some people experience numbness or a pins-and-needles tingling sensation in one or both hands.  This is sometimes accompanied by weakness and loss of fine motor skills.  Over time, it becomes increasingly harder to fasten buttons, use a pen, or perform simple tasks that require small movements.

In exceedingly rare cases, individuals with severe spinal stenosis may experience incontinence, severe weakness in the legs, or loss of feeling in the genitals and inner thighs.  If this happens, contact emergency medical help immediately.  For most people, spinal stenosis is diagnosed and treated before it progresses to this point.

Diagnosing Spinal Stenosis

Your doctor will initially diagnose cervical or lumbar stenosis based on your symptoms, medical history, risk factors (such as age and injury), and a complete physical exam.  To confirm the diagnosis, they will use imaging procedures to determine the cause of your symptoms.  These may include x-rays of the spinal column, MRIs, and CT scans.  These techniques can reveal bone spurs, herniated discs, tumors, and areas where there is pressure on the spinal cord or nerves.

Conservative Treatments for Spinal Stenosis

There are several treatment options for mild to moderate spinal stenosis.  Your doctor can help determine the best treatment (or combination of treatments) for you based on the severity of your condition and your pain level.

Conservative treatments for mild to moderate spinal stenosis may include:

  • Pain relievers such as naproxen, ibuprofen, or acetaminophen for short-term relief
  • Antidepressants to minimize chronic pain and any resulting minor depression
  • Prescription opioids such as hydrocodone (used sparingly for short periods of time)
  • Physical therapy to improve muscle tone and strength, maintain spinal stability, and improve balance
  • Steroid injections to reduce the inflammation of irritated nerves

While these methods don’t correct spinal stenosis and may not work for everyone, they are typically done to reduce swelling, pain, and other symptoms.  Surgery is the last resort after other options for alleviating the symptoms of spinal stenosis have proven ineffective.

Surgical Solutions for Spinal Stenosis

When the symptoms of spinal stenosis become moderate or severe, surgery may be the only option.  This is particularly important when neurological issues, pain, or mobility problems have developed.  The goal of spinal stenosis surgery is to relieve pressure on the nerves or spinal cord so they can heal and return to proper functioning.

Laminectomy

The most common surgical treatment for either cervical or lumbar stenosis is a laminectomy.  During this procedure, two vertebral laminae—which form the “roof” of the spinal canal—and the bony area connecting them are removed, relieving pressure on the spinal cord.  Bone grafts or instrumentation are added to stabilize the site and protect the spinal cord.  Depending on the severity of the stenosis, fusion of the surrounding vertebrae may be performed for added stability.

Transforaminotomy

Transforaminotomy is generally for less severe cases of lumbar stenosis.  This option is not as involved as a laminectomy and is reserved for situations when the stenosis is restricted to a small area of the lumbar spine.  Transforaminotomy involves the widening of the bony openings between affected vertebrae, including the removal of any bone spurs that have developed.  Your surgeon may also remove damaged soft tissue or herniated discs.

Discectomy

If spinal stenosis is caused by a degenerated or herniated disc pressing on a nerve or the spinal cord, discectomy surgery may be done to remove all or part of the affected disc.  Partial discectomies are typically performed for lumbar stenosis, while complete discectomies are more common for cervical stenosis.  Your surgeon may fuse the surrounding vertebrae if needed.

Any of these surgical procedures may include minimally invasive options, depending on the severity of the spinal stenosis.  After surgery, appropriate care must be taken to allow the area to heal.  In some cases, patients will need physical therapy to ensure proper mobility following surgery.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is Spinal Stenosis?

From WebMD

Cervical Spinal Stenosis

Spinal stenosis is a condition, mostly in adults 50 and older, in which your spinal canal starts to narrow. This can cause pain and other problems.

Your spine is made up of a series of connected bones (or “vertebrae”) and shock-absorbing discs. It protects your spinal cord, a key part of the central nervous system that connects the brain to the body. The cord rests in the canal formed by your vertebrae.

For most people, the stenosis results from changes because of arthritis. The spinal canal may narrow. The open spaces between the vertebrae may start to get smaller. The tightness can pinch the spinal cord or the nerves around it, causing pain, tingling, or numbness in your legs, arms, or torso. Read more