1. An Overview of Spinal Stenosis
Spinal stenosis is a degenerative spine condition that describes the gradual
narrowing of the spinal canal. This condition normally develops as a result of
regular wear and tear on the spinal anatomy, and can lead to a variety of painful
symptoms in the back, neck, and throughout the body if the spinal cord or a
nerve root becomes compressed. In order to effectively treat spinal stenosis, a
doctor must diagnose the source of the constriction and work with a patient to
develop a custom treatment regimen to alleviate the patient’s symptoms.
The Spinal Column
The spinal column is a tightly packed, highly pressurized part of the body where various anatomical
elements work in congress with one another to allow for the full range of motion that we require from
our back and neck. Some of these spinal components include:
Vertebrae – the bones in the spinal column that support much of the body’s weight and also
protect the spinal cord and nerve infrastructure in the spinal canal
Intervertebral discs – thick, spongy pads that cushion and separate adjacent vertebrae in the
spine
Facet joints – vertebral joints that are coated in a thin layer of cartilage and encapsulated with a
thick lubricating fluid; these joints stabilize the spine and also allow for flexibility
Nerves – the spinal cord branches from the base of the brain and travels through the spinal
canal; various nerve roots extend off the spinal cord along the way and exit the spine through
small lateral passageways between the vertebrae
Muscles, ligaments, and tendons – soft tissue that provides support to the back and neck
Spine Degeneration
The problem with the spinal column is that the anatomical elements described above are prone to
degenerate as a result of years of wear and tear. Some degree of spinal deterioration is entirely normal.
As we grow older, the spine naturally begins to weaken in a phenomenon that is as common as hair
graying or skin wrinkling. With time, the intervertebral discs weaken and can bulge or rupture, the
vertebral facet joints can become arthritic, muscles weaken, ligaments calcify, vertebrae shift out of
place, and a number of other similar changes occur. It is this degeneration that accounts for the loss of
flexibility and the minor aches and pains that most people accept as being part of the aging process.
The issue with spinal degeneration, however, is that a problem with one spinal component has a
tendency to snowball and affect other areas of the spine, exacerbating the spinal condition and
subsequent symptoms. Spinal stenosis is a good example of this snowball effect. Normally, the spinal
canal has just enough room for the spinal cord and its nerve roots. Stenosis occurs when this
passageway becomes constricted either as a result of spinal misalignment or because of the presence of
degenerated spinal material, such as a herniated disc or bone spurs.

2. The important thing to understand about spinal stenosis, though, is that the mere narrowing of the
spinal canal is not inherently symptomatic. Instead, symptoms only develop when a nerve within the
canal becomes constricted or compressed as a result of the stenosis.
Symptoms
While some degree of spinal degeneration is entirely normal, when the deterioration
advances to the point that a nerve root or the spinal cord becomes compressed,
chronic pain and other similar symptoms will develop. The specific symptoms that an
individual will experience depend entirely on the location of the nerve compression,
the extent of the irritation, and the cause of the problem. When a nerve root is
compressed in the spinal column, symptoms can actually be transferred along the
length of the nerve, affecting the various muscles and muscle groups innervated by
that particular nerve. For example, spinal stenosis in the neck (cervical spine) can lead to pain in the
shoulders, arms, hands, fingers, and throughout the upper body; alternatively, the same condition in the
lower back (lumbar spine) can cause symptoms to develop in the buttocks, hips, legs, feet, toes, and
throughout the lower body.
Specific symptoms will vary from patient to patient, but common examples of spinal stenosis symptoms
include:
Numbness and tingling in the extremities
Muscle weakness
Diminished reflexes
A sensation of heat or pins-and-needles
Joint stiffness or soreness
Diagnostics
Before any treatment regimen can begin for spinal stenosis, it is absolutely essential to diagnose the
exact cause and location of the nerve compression. When spinal stenosis is caused by a herniated disc or
a bulging disc, for example, the approach will be different than for an individual who suffers from
spondylolisthesis (vertebral misalignment).
The only way to absolutely ascertain a spinal stenosis diagnosis is to visit a spine specialist. While the
diagnostic process will obviously vary depending on the doctor, this process normally entails a review of
a patient’s medical history, a thorough physical examination, and usually some form of medical imaging.
During the medical history review, the doctor will ask the patient a series of questions designed to help
the doctor better understand the patient’s symptoms and condition, especially if the cause of the
patient’s discomfort isn’t readily apparent. It is extremely important for the patient to be as exhaustive
with their answers as possible during this process because even the smallest detail may greatly impact
the doctor’s diagnosis. After the review is completed, the doctor will next test neuropathic response
(reflexes), check range of motion, and apply pressure to the area surrounding the back and neck to help

3. confirm the diagnosis. Finally, the use of an X-ray, MRI, or CT scan may be warranted to pinpoint the
origin of the problem and also ensure that no underlying problem is contributing to the patient’s pain.
Treatment
Once a spinal stenosis diagnosis has been made, the doctor will be able to work with the patient to
determine the best course of treatment. In most cases, an individual experiencing nerve compression as
a result of spinal stenosis will be first recommended a variety of nonsurgical, conservative techniques.
These treatments typically do not provide instant relief but are instead designed to gradually alleviate
the symptoms by strengthening the back, neck, and core muscles, and increasing spinal flexibility over
the course of several weeks.
Often, conservative treatment is the product of trial-and-error. What works for one patient may not be
viable for another because of a number of variables such as a patient’s health, the exact cause of the
stenosis, or the specific symptoms he or she experiences. As a result, a patient must have the proper
expectations and patience to be willing to try several different methods until the right combination is
found. It can be an inexact science.
Here are a few examples of common initial treatments:
Nonsteroidal anti-inflammatory drugs
Low-impact exercises, such as jogging or swimming
Stretching techniques
Limited rest
Neck or back bracing
Hot/cold therapy
In most cases, conservative techniques will offer sufficient relief from spinal stenosis. However, for a
select segment of the population, decompression surgery may be warranted. In this case, it is up to a
patient to research his or her options and learn the advantages and limitations of both endoscopic spine
procedures and open spine surgeries.
To learn more about spinal stenosis, speak with your doctor today.