Spinal stenosis

This information may be useful if you have been diagnosed with spinal stenosis. That includes cervical stenosis and lumbar stenosis. If you are having new symptoms, or symptoms that don't go away, contact your doctor.

Spinal stenosis is a narrowing of the tunnels in the spine that hold the nerves or the spinal cord. It's common. Most of this narrowing is just a normal part of getting older, and it often causes no problems at all.

Sometimes, though, spinal stenosis irritates or squeezes the nerves. It can happen in any part of the spine, but it's most common in the lower back (lumbar stenosis) and the neck (cervical stenosis). When it does cause trouble, you may feel pain in the lower back and legs, or in the neck, arms and hands.

Even when stenosis does cause pain, the nerves can learn to adapt to the narrower space. Most people with the condition manage their symptoms well once they have the right advice and information.

Some people do need further help, especially if the symptoms affect how well an arm or leg works, make walking difficult, or are spoiling their quality of life.

Spinal stenosis doesn't look the same in everyone, and the symptoms can differ a good deal from one person to the next. Many people have no symptoms at all. Some people can have both lumbar and cervical stenosis at the same time, though that is uncommon.

Lumbar spine stenosis mostly shows up in the legs. You may notice:

• pain
• aching
• cramping
• heaviness and or weakness
• tingling
• pins and needles
• numbness

These symptoms are usually worse when you walk or stand, and they ease when you sit down or lean forward.

Cervical spine stenosis mostly shows up in the arms. The symptoms can include:

• pain
• stiffness
• weakness
• tingling
• pins and needles
• numbness

You may also get headaches.

People with spinal stenosis can have back or neck pain too. But if you have no leg or arm symptoms, low back pain or neck pain is usually not thought to come from stenosis.

Spinal stenosis is a long term condition, and the symptoms can change from time to time. Many people find that managing their symptoms helps improve their quality of life.

Symptoms usually get worse only slowly. That gives time to keep an eye on them and to think about treatments.

A doctor can diagnose spinal stenosis after an assessment. They will ask you about your symptoms and examine you physically.

Sometimes they may advise further tests to rule out other serious health conditions. If your symptoms are severe and getting worse, scans may be considered to help decide whether spinal surgery could help.

As we get older, the spine ages too, and this can narrow the tunnel around the spinal cord or nerves, leaving them less space. That is how spinal stenosis often begins. Other causes include:

• injury
• rheumatoid arthritis
• certain bone diseases
• being born with a narrow spinal canal

Many people have no symptoms at all. In some, though, the narrowing can irritate these tissues. The nerves can also learn to cope with a narrower tunnel, and pain does not always mean the nerves are being damaged.

Pain can also be shaped by anything that affects your general health, such as poor sleep, stress and your emotional wellbeing.

Many people with spinal stenosis have a mix of pain, numbness and weakness in the low back and legs, or in the neck and arms. These symptoms can be distressing, but they don't necessarily need urgent medical attention.

Occasionally, spinal stenosis can lead to two serious conditions, cauda equina syndrome or cervical myelopathy. Both are rare, but they can cause permanent damage or disability. Spotting them early and starting treatment can stop things getting worse. If you develop either of these conditions, you may need to be seen by an emergency specialist team.

Speak to your doctor urgently if you have a new problem, or a clear worsening of an existing one, with any of the following:

• changes to bladder and bowel function, like urgency, frequency, difficulty passing urine, leaking or incontinence
• changes to sensation around the bottom and/or genitals, or sexual dysfunction, like a recent inability to achieve orgasm or erection
• reduced balance or difficulty walking
• pain, weakness, heaviness or changing sensation in the arms or legs
• clumsy hands, for example dropping things, or struggling with handwriting, buttons or zips
• neck pain together with a severe headache

If your doctor's chamber is closed, call a doctor or the 16263 health line.

• you also feel generally unwell
• you have neck pain that starts when you are ill with other problems, such as rheumatoid arthritis or cancer

Many people with spinal stenosis can cope with their symptoms, because given time the nerves can adapt. The way it's managed depends on a few things, including your symptoms, your general health and what you would prefer yourself.

The treatment options include:

• Exercise can reduce nerve irritation and make the nerve more resilient to movement. It won't change the narrowing of the spinal tunnel itself.
• Exercise may also help with your general function, muscle strength and balance.
• Physiotherapy can help too. Your doctor may refer you to it, or you may be able to arrange it yourself.

• staying active
• modifying activities and pacing techniques
• maintaining a healthy weight
• stopping smoking
• managing stress and emotional wellbeing

• medication
• heat
• ice

Read more about taking painkillers.

Along with these treatments, your doctor may advise you to keep an eye on any changes in your symptoms.

If your symptoms of spinal stenosis aren't getting better and you've already tried other treatments, there are a few more options a doctor may talk through with you:

• spinal injections
• spinal surgery
• specialist pain services

If you've been diagnosed with lumbar stenosis, walking can be uncomfortable. Even so, it's safe to keep walking as long as your symptoms stay manageable. Short walks, done regularly, are encouraged because they help manage your symptoms.

Your leg symptoms may ease when you bend or lean forward. If that's the case, it may help to take regular breaks while you walk. You can sit down for a while or lean against a wall.

If walking has become a struggle, it may help to talk to a doctor about a walking aid.

Spinal stenosis can sometimes mean you need to take some time off work. How much time depends on what your symptoms are like and what your job involves.

You don't have to be free of symptoms before you think about going back. Carrying on with work, or returning as soon as you can, will help your recovery. Getting back to your normal daily activities bit by bit can help build up your strength and stamina.