Spinal stenosis is a narrowing of the spaces within the spine, which puts pressure on the spinal cord and the nerves that travel through the spine. It most commonly occurs in the lumbar (lower back) and cervical (neck) regions. The condition develops gradually as age related changes in the spine reduce the available space for the neural structures.
Lumbar spinal stenosis is one of the most common reasons for spine surgery in adults over 65. The narrowing is caused by a combination of disc bulging, thickening of the spinal ligaments, and enlargement of the facet joints, all of which progressively encroach on the spinal canal.
Characteristic Symptoms
The symptoms of spinal stenosis are distinctive and often follow a predictable pattern. Lumbar stenosis classically causes neurogenic claudication, which is leg pain and heaviness that worsens with walking or standing and improves with sitting or bending forward.
- Leg pain, heaviness, or cramping that worsens with walking or standing
- Symptoms that improve when sitting, bending forward, or leaning on a shopping cart
- Progressive decrease in walking distance over months to years
- Numbness or tingling in the legs or feet
- Weakness in the legs
- For cervical stenosis: hand clumsiness, difficulty with fine motor tasks, balance problems, and gait unsteadiness
- Cervical stenosis may also cause neck and arm pain with numbness
When Conservative Care Is Not Enough
Initial treatment includes physical therapy, anti inflammatory medications, and epidural steroid injections. These measures can provide significant relief for many patients. Surgery is considered when symptoms are progressive, walking ability is significantly limited, or there is evidence of neurological decline. Dr. Waldron performs decompressive laminectomy (with or without fusion) to open the spinal canal and relieve pressure on the nerves.