What is Spinal Stenosis?
Spinal stenosis occurs when the space around the spinal cord narrows. This puts pressure on the spinal cord and the spinal nerve roots, and may cause pain, numbness, or weakness in the legs.
What Causes Spinal Stenosis?
Arthritis is the most common cause of spinal stenosis. In the spine, arthritis can result as the disc degenerates and loses water content. As we get older, our discs begin to dry out and weaken. This problem causes settling, or collapse, of the disc spaces and loss of disk space height. As the spine settles, two things occur. First, weight is transferred to the facet joints. Second, the tunnels that the nerves exit through become smaller. As the facet joints experience increased pressure, they also begin to degenerate and develop arthritis, similar to that occurring in the hip or knee joint. The cartilage that covers and protects the joints wears away. If the cartilage wears away completely, it can result in bone rubbing on bone. To make up for the lost cartilage, your body may respond by growing new bone in your facet joints to help support the vertebrae. Over time, this bone overgrowth-called spurs-may narrow the space for the nerves to pass through. Another response to arthritis in the lower back is that ligaments around the joints increase in size. This also lessens space for the nerves. Once the space has become small enough to irritate spinal nerves, painful symptoms result.
How does Spinal Stenosis Cause Pain and What are the Symptoms?
Pressure on spinal nerves can result in pain in the areas that the nerves supply. The pain may be described as an ache or a burning feeling. It typically starts in the area of the buttocks and radiates down the leg. As it progresses, it can result in pain in the feet. Studies of the lumbar spine show that leaning forward can actually increase the space available for the nerves. Many patients may note relief when leaning forward and especially with sitting. Pain is usually made worse by standing up straight and walking. Some patients note that they can ride a stationary bike or walk leaning on a shopping cart. Walking more than 1 or 2 blocks, however, may bring on severe sciatica or weakness.
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