Spinal Stenosis

Getting diagnosed with spinal stenosis can bring up many questions. What does it mean? Will it get worse? Do I need surgery? The good news is that many people can manage their symptoms with the right treatment. Understanding what your condition is can help you find relief and stay active.

At Banner Health, our spine specialists have vast experience in treating spinal stenosis. They work with you to create personalized plans to reduce symptoms, improve movement and help you get back to doing the things you enjoy.

What is spinal stenosis?

Your spine is made up of a column of small bones called vertebrae. Inside these bones is a hollow space called the spinal canal. The spinal canal protects your spinal cord, which carries messages between your brain and the rest of your body. Nerve roots branch off from the spinal cord and pass through small openings in the spine to reach your arms, legs and other parts of your body.

Spinal stenosis happens when the spinal canal or the openings where nerves leave the spine become too narrow. When this space gets smaller, it can put pressure on the spinal cord, the nerve roots or both. This pressure can disrupt how nerves send signals and cause symptoms like pain, numbness, tingling or weakness.

Spinal stenosis usually develops slowly over time as the spine changes with age. Some people have spinal stenosis without realizing it because they have no symptoms. Others develop symptoms that get worse gradually as the narrowing increases.

Types of spinal stenosis

Spinal stenosis can happen anywhere along the spine, but it primarily affects three areas:

• Lumbar spinal stenosis: The lumbar spine, or lower back, consists of five vertebrae (L1 to L5). Lumbar spinal stenosis is the most common type. It puts pressure on the nerves that extend into the buttocks, legs and feet.
• Cervical spinal stenosis: Cervical spine stenosis is a condition that affects the neck. It can put pressure on the spinal cord or the nerves that travel into the shoulders, arms and hands. Because the spinal cord passes through the neck, cervical stenosis can sometimes cause problems with balance, hand dexterity and coordination.
• Thoracic spinal stenosis: Your middle back (thoracic spine) can also develop spinal stenosis, though it is much less common. Thoracic spinal stenosis can still put pressure on the spinal cord or nearby nerves. It can cause pain, poor balance, numbness, leg weakness or symptoms that wrap around the chest or abdomen.

Symptoms of spinal stenosis

Spinal stenosis symptoms often develop slowly and may come and go at first. The symptoms you experience depend on where the narrowing is in your spine and whether it presses on the spinal cord, nerve roots or both.

Lumbar spinal stenosis

Symptoms may include:

• Lower back pain
• Pain that spreads into the buttocks, legs or feet
• Numbness or tingling in the legs or feet
• Weakness in the legs
• Cramping or heaviness in the legs
• Difficulty walking or standing for a long time
• Symptoms that improve when sitting or bending forward

Many people notice their symptoms worsen when standing or walking and get better when they lean on a shopping cart, walker or counter. This is known as the shopping cart sign and is a common symptom of lumbar spinal stenosis.

You can find more information about the shopping cart sign in our related blog post.

Cervical spine stenosis

Symptoms may include:

• Neck pain
• Pain that travels into the shoulders, arms or hands
• Numbness or tingling in the arms or hands
• Weakness in the arms or hands
• Problems with balance or walking
• Hand clumsiness or difficulty with fine motor tasks, such as buttoning clothes or writing

Thoracic spinal stenosis

This condition is less common but may cause:

• Mid-back pain
• Pain that wraps around the chest or abdomen
• Numbness or tingling
• Muscle weakness
• Difficulty with balance or walking

What causes spinal stenosis

Age-related changes in the spine usually cause spinal stenosis. Common causes include:

• Arthritis in the spine (facet arthritis)
• Bone spurs (overgrowth of bone)
• Thickened spinal ligaments
• Herniated or bulging disks
• Degenerative disk disease
• Spinal instability or spondylolisthesis
• Spinal fractures or injuries
• Prior spine surgery

Less commonly, it can be caused by:

• Spinal cysts or tumors
• Infection
• Congenital conditions you are born with

Your provider can help determine what's causing your spinal stenosis and recommend the most appropriate treatment.

How spinal stenosis is diagnosed

Your health care provider will begin with a medical history and physical exam. They’ll ask you about your symptoms, when they happen and how they affect your daily life.

During your exam, your provider may check:

• Muscle strength
• Reflexes
• Sensation (feeling)
• Balance
• Walking pattern (gait)
• Neck or back movement
• Signs of nerve or spinal cord compression

Imaging and other tests may include:

• Spine X-ray
• MRI
• CT scan or CT myelogram
• EMG or nerve conduction studies, when needed
• Diagnostic injections in select cases

Learn more about spine testing and diagnosis.

Treatment options for spinal stenosis

Treatment depends on where the stenosis is located, how severe it is and how much it affects your quality of life.

Nonsurgical treatment

Doctors often start with conservative, noninvasive treatments before considering surgery. This may include one or more of the following:

• Heat and ice therapy
• Regular exercise to strengthen back muscles
• Physical therapy
• Over-the-counter (OTC) or prescription pain-relieving medication
• Corticosteroid injections or nerve blocks
• Walking aids or supportive devices like bracing

Surgery for spinal stenosis

If conservative treatment doesn’t help, surgery may be necessary. Surgical treatment options may include:

• Laminectomy (decompression surgery)
• Foraminotomy to widen the nerve opening
• Spinal fusion in select cases
• Artificial disc replacement, in select cases
• Other procedures based on the location and cause of compression

Learn more about spine surgery types and treatments.

When to seek medical care

Talk to a spine specialist if your symptoms don’t get better or make it hard to do daily activities. Getting help early can prevent symptoms from getting worse.

You might want to see a spine doctor if you have:

• Back or neck pain with numbness or tingling
• Pain that goes into an arm or leg
• Weakness in your arms, hands, legs or feet
• Trouble walking or standing for a long time
• Heaviness or cramping in your legs
• Balance problems
• Hands that feel clumsy
• Symptoms that keep coming back
• Symptoms that are getting worse

Call 911 or go to the nearest emergency room if you develop:

• Loss of bladder or bowel control
• Numbness in the groin or saddle area
• Severe leg weakness
• Sudden severe back pain with leg symptoms

These may be signs of a serious spine condition that needs immediate treatment.

Living with spinal stenosis

Living with this condition can make it harder to walk, stand, lift or use your hands. Many people find ways to manage their symptoms successfully with the right treatment plan. Your care team can help you stay active and maintain your quality of life.

You can help manage your condition by:

• Following your physical therapy plan
• Taking your medications as directed
• Balancing activity with rest
• Wearing supportive footwear if recommended
• Using walking aids if needed
• Avoiding activities that make symptoms worse
• Going to all your follow-up appointments
• Telling your provider if your symptoms change

Why choose Banner Health for spinal stenosis care?

Banner Health provides comprehensive care for spinal stenosis and other spine conditions. Our specialists work together to develop personalized treatment plans based on your symptoms, lifestyle and goals.

We provide:

• Evaluation of back, neck, arm and leg symptoms
• Treatment for lumbar, cervical and thoracic spinal stenosis
• Advanced imaging and nerve testing when needed
• Physical therapy and other nonsurgical options
• Spine injections and pain management procedures
• Surgical consultation for severe or ongoing nerve compression
• Coordinated care through Banner Health

Whether you're just starting to notice symptoms or have been living with spinal stenosis for years, we're here to help you find the right treatment.

Make an appointment today.

Learn more about spine care.

FAQs

What is spinal stenosis?

Spinal stenosis is narrowing inside of the spine. This narrowing can put pressure on the spinal cord or nerves, causing pain, numbness, tingling or weakness.

What does spinal stenosis feel like?

Symptoms vary depending on where the narrowing happens. You might feel back or neck pain, pain that spreads into your arms or legs, numbness, tingling, weakness, leg cramps or trouble walking or standing for a long period.

Is spinal stenosis the same as sciatica?

Sciatica is pain, numbness or tingling that follows the path of the sciatic nerve. While spinal stenosis can cause symptoms similar to sciatica, sciatica can also be caused by other problems, like a herniated disk.

What is the shopping cart sign?

The shopping cart sign describes leg pain, heaviness or cramping that improves when you lean forward, such as over a shopping cart. It is a common symptom of lumbar spinal stenosis.

Can spinal stenosis get better without surgery?

Yes. Many people improve with physical therapy, medications, activity changes and spine injections. Surgery is usually considered only when symptoms are severe, worsening or not improving with conservative treatment.

When is spinal stenosis serious?

Seek emergency care if you develop loss of bladder or bowel control, numbness in the groin or saddle area, severe weakness or sudden severe back pain with leg symptoms. These symptoms may signal a medical emergency.

What kind of doctor treats spinal stenosis?

Spinal stenosis may be treated by neurosurgeons, orthopedic spine specialists, neurologists, pain management specialists, physical therapists and other spine care providers. At Banner Health, these specialists work together to provide coordinated care.