Stenosis is the narrowing of the spinal canal. Typically, the tunnels in vertebrae are quite spacious and much larger than the spinal cord and nerves that pass through them. However, some patients are genetically programmed to have smaller size tunnels in the spine, predisposing them to develop symptoms from spinal stenosis. Arthritic changes such as bone spurs, thickened ligaments, joint laxity and disc bulges can cause stenosis, as can disc herniations or fractures.

 

Each lumbar vertebra has three tunnels that can be affected by stenosis. The large tunnel in the middle of the vertebra is where the spinal cord and all of the spinal nerves are contained. A much smaller tunnel is on each side of the vertebra, where the individual nerves exit the spine. Narrowing of any of these tunnels can result in pressure on the spinal cord or spinal nerves. 

 

Patients with lumbar spinal stenosis typically have lower back pain along with pain in the buttocks and legs. This usually affects patients more when they are standing or walking, and pain is often relieved when sitting or lying. Many patients report that the decrease in their ability to walk is the most bothersome part of the condition. Some have found that leaning forward, such as using a cart while shopping, helps to ease pain. 

 

Other conditions such as poor blood circulation to the legs, diabetic neuropathy and hip or knee arthritis have very similar symptoms to spinal stenosis.

 

Conservative treatments such as over-the-counter anti-inflammatory medication, physical therapy and chiropractic care may give partial relief of symptoms. For more severe symptoms, a series of steroid injections into the spine may calm the inflammation of the nerves and give temporary relief of the buttock and leg symptoms. Though these treatments may help the patient cope with the symptoms for several years, they have little effect on the natural history of the disease, which is slow progression.