Spinal Stenosis

Spinal Stenosis Can Cause Neck and Back Pain

Spinal stenosis is a spine problem that may gradually cause neck and back pain. It may be accompanied by neurological symptoms, such as numbness, tingling sensations, or weakness. It occurs when the spinal canal and/or nerve passageways narrow, which squeezes nerve structures. When the spinal canal is affected, the disorder is called central stenosis. When the spinal nerves exiting the spinal canal are affected, it is called lateral recess stenosis or foraminal stenosis. Foramen is the term for the nerve passageways through which nerves exit the spinal canal. Basically, spinal stenosis is a nerve compression problem, and there are many spinal conditions than can cause or contribute to the development of stenosis.

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Examples of types of cervical (neck) spinal stenosis

Potential Symptoms and Affects

Where pain and symptoms are felt depends on where and at what level spinal stenosis occurs. Of course, the severity of spinal cord or nerve root compression greatly affects pain and symptoms. Although pain is often the foremost symptoms of spinal stenosis, the symptoms patients experience vary.

  • Cervical spinal stenosis: pain, stiffness, numbness, tingling, and/or weakness in the neck, shoulders, arms, and/or hands. Some patients with cervical spinal stenosis experience balance problems or trouble walking (eg, shuffling).
  • Lumbar spinal stenosis: pain, stiffness, numbness, tingling, and/or weakness in the low back, buttocks, thighs, and/or legs. Patients often experience pain when standing or walking. Pain typically improves with rest. Sometimes leg pain and weakness occur without back pain.
  • Although it is rare, cervical or lumbar spinal stenosis may cause bowel and/or bladder dysfunction. Bowel or bladder dysfunction (eg, incontinence) requires urgent medical attention.

Typical Causes of Spinal Stenosis in the Neck or Back

Spinal stenosis is usually caused by age-related degenerative changes affecting the spine’s discs. Degenerative disc disease, although not a disease, is most common in people age 50 or older. During this time of life, the onset of aging may become more noticeable (eg, facial wrinkles). Similar cellular changes affect the spine too, especially the intervertebral discs.

The effects may be described as a cascade of changes:

  • Fluid volume in a disc reduces and may affect its strength and flexibility.
  • The shape and height of the disc are altered; disc height is lost.
  • Lost disc height reduces the amount of space between the disc’s upper and lower vertebral bodies, which may compress (squeeze) a nerve root.
  • Degenerative changes may further weaken the disc.
  • The disc bulges or herniates causing adjacent nerve compression, inflammation, pain, and other symptoms.

Furthermore, lost disc height compromises the function of the facet joints. Osteophytes—bone spur formation—is another degenerative development. Bone spurs may grow into the spinal canal and compress the cord (central canal spinal stenosis).

Another cause of central canal spinal stenosis is thickening of spinal ligaments, most noticeably the ligamentum flavum. This ligament in situated inside the spinal canal. It connects the vertebrae together starting at the base of the skull to the sacrum (lower back). When the ligament thickens, it enlarges and may buckle and cause spinal cord compression.

Is spine surgery the only treatment?

Many patients with spinal stenosis in the neck or back respond well to non-surgical treatment. An accurate diagnosis is essential to any treatment plan. The first line of non-operative therapy often includes anti-inflammatory medication and physical therapy. Your neurosurgeon may recommend a spinal injection, which offers diagnostic value as well as potential pain relief.

At Charleston Brain and Spine, our neurosurgeons involve patients in an honest discussion of their diagnosis and treatment options. It is important to us that you understand the potential benefits and risks of any treatment. Be assured that your care is our utmost concern. Being a neurosurgical group, does not mean that surgery is the only treatment we offer! Rather, we offer a wide range of non-surgical treatments.