Spinal Stenosis: What is it?

By Christina Lasich, MD

Damage to the spinal cord, an information superhighway that originates in the brain, is a very devastating injury that can lead to paralysis. Most people have heard of traumatic spinal cord injuries because the sudden tragedies grab headlines from time to time.  But, few people have heard of spinal stenosis, a narrowing of the tube which shelters the spinal cord called the spinal canal (See Spine Anatomy 101). As the space tightens like a noose, this slow strangulation of the nerves in the spine can disrupt anyone’s life.

Sara turned 68 years old last month. She has enjoyed good health and has been an avid golfer. But, lately she has noticed an aching pain in her legs that occurs when she is walking or standing. This new problem has really slowed her golf game down and has made it difficult for her to even do her own grocery shopping. The only way she can make it up and down the aisles is by leaning on the shopping cart because that eases her pain. Frustrated, she calls to make an appointment with her doctor.

Spinal stenosis usually becomes noticeable in the 5th or 6th decade of life. Sara’s story typifies the usual first symptoms of aching pain in one or both legs. How can a healthy woman acquire spinal stenosis? The key word is “acquire” because Sara was not born with narrow spinal canal. Although, changes to her spine have accumulated as she has gotten older. As the discs degenerate, an avalanche of problems effect the surrounding structures particularly the spinal facet joints. These joints, like finger joints, will start to swell and grow (hypertrophy) as they deteriorate. Large knuckle joints in the fingers are not such a big deal. However, big facet joints are a big deal because of the confined, small space within the spine. Any unusual growth, swelling, buckling or bulging can crowd the spinal cord as the walls close in around it in a noose-like fashion. Other parts of the spine, besides facet joints, can cause spinal stenosis. Abnormal discs, ligaments and bones can all lead to a pinched, crowded, and confined spinal cord. Sometimes people are born with deformed spinal structures (congenital spinal stenosis) and others, like Sara, develop abnormal narrowing over time (acquired spinal stenosis). But eventually, both roads lead towards the same result: very unhappy nerves that are being strangled.

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