What is canal stenosis? Canal stenosis involves thenarrowing of the spinal canal, which is the passagewaythrough which the spinal cord runs. The canal itself,which is sometimes called the vertebral cavity, is formedby stacked, ring-like bones called vertebrae. There are avariety of reasons that a section of the spinal canal couldbecome narrowed. Usually it involves an anatomicalabnormality like a herniated disc, bulging disc, bone spur,or a slipped vertebra (spondylolisthesis). Degenerationrelated to the aging process is the primary reason thatthese conditions can develop, though injuries, genetics,repetitive spinal stress, and poor posture are amongother common causes of canal stenosis.
Canal Stenosis vs. Foraminal StenosisAlthough the conditions are similar, canal stenosis should be differentiated from foraminal stenosis, whichis the narrowing of a vertebral foramen. The vertebral foramina are openings on either side of eachvertebra through which spinal nerve roots pass as they exit the spinal cord and branch off toward otherareas of the body. The foramina can become narrowed due to the same conditions that can affect thecentral canal.Canal stenosis and foraminal stenosis are generally not painful conditions in and of themselves, but if thesepassageways become narrowed to the point that a neural structure is compressed, symptoms can arise.Canal stenosis is more likely to cause compression of the spinal cord, which may lead to myelopathicsymptoms like: • Weakness or spasticity in the muscles of the back, neck, and/or extremities • Sensory problems • Problems with balance or gait • Bladder or bowel dysfunction, which should be treated as medical emergencyForaminal stenosis is more likely to cause compression of a spinal nerve root, which may lead toradiculopathic symptoms like: • Tingling or a pins-and-needles sensation in the back, neck, and or/extremities • Shooting pain, or pain that feels warm or electric • Muscle weakness or cramping
Conservative Treatments for Canal StenosisOnce you receive a professionaldiagnosis of canal stenosis, yourdoctor will likely prescribe a regimenof nonsurgical treatments to helprelieve symptoms associated withneural compression. Common conservative approaches topain relief include non-steroidal anti-inflammatory drugs,hot/cold compresses, physical therapy, stretching, low-impact exercise, corticosteroid injections, andtranscutaneous electrical nerve stimulation, among others.
Alternative & Complementary Medicine for Canal StenosisSome patients have been able to find relief from their canalstenosis symptoms with the use of complementary and alternativemedicine (CAM). This involves products and practices aimed athealth and wellbeing that are not typically part of conventional, orstandard, medicine. While some forms of CAM are aimed more atpreventing the onset of certain health conditions, there are alsomany therapies that may be able to help alleviate the painassociated with a chronic condition like canal stenosis. Examplesmay include yoga, massage, acupuncture, and herbal supplements.Be sure to consult with your primary care physician or a spinespecialist before integrating or replacing any aspect of yourprescribed treatment regimen with complementary or alternativetherapies.
Surgery for Canal StenosisFor the majority of people with symptomatic canal stenosis, surgery will not become aconsideration. Conservative treatments are usually effective at mitigating thesymptoms enough that an individual can remain active and maintain a high quality oflife. If, however, several weeks or months of conservative treatments do not help yoursymptoms to abate, surgery may become an option. There are generally two types ofsurgery available for patients with canal stenosis: endoscopic surgery and open spinesurgery. Endoscopic surgery is a minimally invasive, outpatient procedure that involvesless risk of complications, but not all patients will be candidates for this type ofprocedure.If you are considering surgery for canal stenosis, foraminal stenosis, or any other kindof degenerative spine condition, the important thing to keep in mind is that electivesurgery should only be a last resort option. Speak with a variety of spine specialistsabout whether surgery is really your only hope for meaningful pain relief, and alwaysask if there are additional conservative treatments you can try.