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Many people have evidence of spinal stenosis on X-rays, but have no signs or symptoms. When symptoms do occur, they often start gradually and worsen over time. The most common parts of the spine affected by spinal stenosis are the neck and lower back. Symptoms vary, depending on the location of the stenosis.

Spinal stenosis in the neck

• Numbness or weakness. Spinal stenosis in your upper (cervical) spine can cause numbness, weakness or tingling in a leg, foot, arm or hand. You may drop things more often or have a tendency to fall.
• Neck or shoulder pain. This may occur if the nerves in your neck are compressed. However, cervical spinal stenosis often causes no pain. And neck pain can be caused by problems other than spinal stenosis.
• Loss of bowel or bladder control. In severe cases of cervical spinal stenosis, nerves to the bladder or bowel may be affected, leading to incontinence.

Spinal stenosis in the lower back
Compressed nerves in your lower (lumbar) spine can cause pain or cramping in your legs when you stand for long periods of time or when you walk. The discomfort usually eases when you bend forward or sit down.

When to see a doctor
Call your doctor if you have numbness or weakness in your back, legs, neck or arms.

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Many different types of problems can reduce the amount of space within the spinal canal. The most common of these problems are related to degeneration and the aging process. Other causes range from birth defects to benign or cancerous tumors.

Aging-related causes

• Osteoarthritis. With time, the facet joints between adjacent vertebrae in your spine deteriorate. In an attempt to repair the damage, your body may produce bony growths called bone spurs. These bone spurs can narrow the spinal passages.
• Disk degeneration. As you age, the cushions between your vertebrae flatten and bulge. Eventually, the tough, fibrous outer covering of the disk may develop tiny tears, causing the jelly-like substance in the disk's center to protrude and press on your spinal cord and nerve roots.
• Thickened ligaments. The tough cords that help hold the bones of your spine together can become stiff and thick over time. The thickening along with bulging into the spinal canal can also narrow the spinal canal and compress nervous tissue.

Other causes of spinal stenosis

• Paget's disease of the bone. In Paget's disease, your body generates new bone at a faster than normal rate. This produces soft, weak bones that are prone to fractures. It can also create bones that are deformed or abnormally large. If this occurs in the spine, it can reduce the amount of space available in the spinal canal.
• Achondroplasia. This genetic disorder slows the rate at which bone forms during fetal development and in early childhood, resulting in dwarfism. People who have this condition are born with narrow spinal canals.
• Spinal tumors. Abnormal growths can form inside the spinal cord, within the membranes that cover the spinal cord or in the space between the spinal cord and vertebrae. Enlarging tumors may compress the spinal cord and nerve roots.
• Spinal injuries. Car accidents and other major trauma can cause dislocations or fractures of one or more vertebrae. Displaced bone from a spinal fracture may damage the contents of the spinal canal. Swelling of adjacent tissue immediately following back surgery also can put pressure on the spinal cord or nerves.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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Spinal stenosis risk factors include:

• Age. Most people with spinal stenosis are over 50 years old.
• Inherited conditions. Some birth defects result in a spinal canal that's smaller than usual. This increases the risk of spinal stenosis.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Spinal stenosis complications vary, depending on which nerves are compressed.

Cervical stenosis complications

• Incontinence. In severe cases of cervical spinal stenosis, you may lose the ability to control your bowels or bladder.
• Weakness or paralysis. Cervical spinal stenosis often causes severe weakness and sometimes paralysis.

Lumbar stenosis complications
Cauda equina syndrome is a rare but serious complication, in which the bundle of nerve roots at the lower end of the spinal cord is compressed. This can cause numbness and paralysis, and emergency surgery may be necessary to relieve the pressure.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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If your family doctor suspects that you have spinal stenosis, he or she may refer you to a doctor who specializes in disorders of the nervous system (neurologist). Depending on the severity of your symptoms, you might also be referred to a spinal surgeon.

What you can do
Before the appointment, you might want to prepare a list that answers the following questions:

• When did you first notice this problem?
• Has it worsened with time?
• Do you have pain? Where is it? What makes it better and worse?
• Do you have any weakness, numbness or tingling?
• Do you have any difficulty controlling your bowel or bladder?

What to expect from your doctor
During the physical exam, your doctor will check:

• The blood flow in your feet vs. limbs
• The range of motion in your neck and lower back
• Your ability to feel pain or temperature
• The strength of your muscles
• The reflexes in your arms and legs
• Your ability to walk

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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Spinal stenosis can be difficult to diagnose because its signs and symptoms resemble those of many age-related conditions. Tests may be needed to help pinpoint the true cause of your signs and symptoms.

Spinal X-rays
Although an X-ray isn't likely to confirm that you have spinal stenosis, it can help rule out problems that cause similar symptoms, including a fracture, bone tumor or inherited defect.

Magnetic resonance imaging (MRI)
In most cases, this is the imaging test of choice for diagnosing spinal stenosis. Instead of X-rays, an MRI uses a powerful magnet and radio waves to produce cross-sectional images of your spine. The test can detect damage to your disks and ligaments, as well as the presence of tumors. Most important, it can show pressure on the spinal cord or spinal nerves.

CT myelogram
Computerized tomography (CT) combines X-ray images taken from many different angles to produce detailed, cross-sectional images of your body — including the shape and size of your spinal canal. In a CT myelogram, the CT scan is conducted after a contrast dye is injected into the spinal column. This outlines the spinal cord and nerves, and can reveal herniated disks, bone spurs and tumors.

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Medications
If over-the-counter pain relievers aren't enough to control your pain, your doctor may prescribe:

• Antidepressants. Nightly doses of tricyclic antidepressants, such as amitriptyline and nortriptyline, may help ease pain caused by spinal stenosis.
• Anti-seizure drugs. Some anti-seizure drugs, such as gabapentin (Neurontin) and pregabalin (Lyrica), are used to reduce pain caused by damaged nerves.
• Opioids. Drugs such as oxycodone (Percocet) and hydrocodone (Vicodin) contain substances related to codeine, which can be habit-forming.

Therapy
A physical therapist can teach you exercises that may help:

• Build up your strength and endurance
• Maintain the flexibility and stability of your spine
• Improve your balance
• Control your pain

Steroid injections
Your nerve roots may become irritated and swollen at the spots where they are being pinched. Injecting a corticosteroid into the space around that constriction can help reduce the inflammation and relieve some of the pressure. However, repeated steroid injections can weaken nearby bones and connective tissue, so only a few injections a year are allowed.

Surgery
Surgery may be considered if:

• More conservative treatments haven't helped
• You're disabled by your symptoms
• You're in good health otherwise

The goal is to relieve the pressure on your spinal cord or nerve roots. For example, a laminectomy removes the back part (lamina) of the affected vertebrae to create more room within the spinal canal. In some cases, vertebrae also may need to be fused together to maintain the spine's strength.

In most cases, surgery helps reduce spinal stenosis symptoms. But some people's symptoms stay the same or get worse after surgery. Surgical risks include infection, a tear in the membrane that covers the spinal cord, a blood clot in a leg vein and neurological deterioration.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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For cervical stenosis

• Apply heat or cold. Some symptoms of cervical spinal stenosis may be relieved by applying heat or cold packs to your neck.
• Avoid injuries. Take great care to avoid injuries to your head and neck, which could rapidly worsen your symptoms.

For lumbar stenosis

• Use canes or walkers. In addition to providing stability, these assistive devices can help relieve pain by allowing you to bend forward while walking.
• Lose excess weight. Extra weight puts additional stress on your joints and bones, particularly those in your lower back.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.