Lumbar Spinal Stenosis

The spinal cord and spinal stenosis

Spinal stenosis is a narrowing of the canal that surrounds the spinal cord.

The spine is made up of bones called vertebrae. The spinal cord runs through an opening in the bones called the spinal canal. Sometimes bones and tissue grow into this canal and press on the nerves that branch out from the spinal cord. This causes pain, numbness, or weakness.

Lumbar spinal stenosis occurs in the low back. Spinal stenosis also can occur in the neck. People who are older than 50 are more likely to get spinal stenosis.

What causes spinal stenosis?

As you age, the bones and tissues in your spine grow and harden. This is a normal part of aging. Discs that act as cushions between the vertebrae may break down. Bony growths called spurs can form. These things can narrow the space in the spinal canal and press on the spinal cord or the nerves that branch out from the spinal canal.

What are the symptoms?

The main symptoms of lumbar spinal stenosis are pain, numbness, or weakness—most often in the legs, feet, and rear end (buttocks). You have it when you walk or stand, but it usually goes away when you sit down. Bending forward a little can ease the pain because it opens up the space in the spinal canal.

How is it treated?

You may be able to treat spinal stenosis with pain medicine and exercises to keep your spine strong and flexible. Your doctor may suggest physical therapy. Some people try cortisone shots to reduce swelling. But if your pain and numbness are so bad that you cannot do normal activities, surgery may be your best option.

The following self-care may help:

  • Take over-the-counter pain medicine if needed. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen seem to be the most effective over-the-counter pain relievers for low back pain. But if you can't take NSAIDs, you can try acetaminophen (Tylenol, for example). Be safe with medicines. Read and follow all instructions on the label.
  • Reach and stay at a healthy weight. Too much weight is hard on your spine.
  • Change sitting positions often to ease pain. For example, lean forward. It may reduce pressure on the spinal cord and its nerves.
  • Exercise as your doctor or physical therapist recommends. Here are a few exercises to try if your doctor says it is okay:
    • Lie on your back, and gently pull one bent knee to your chest. Put that foot back on the floor and then pull the other knee to your chest.
    • Do pelvic tilts. Lie on your back with your knees bent. Tighten your stomach muscles as if you were pulling your belly button in and up toward your ribs. You should feel like your back is pressing to the floor and your hips and pelvis are slightly lifting off the floor. Hold for 6 seconds while you breathe smoothly.
    • Press your back flat against a wall and slide down into a half squat. Hold for 6 seconds while you breathe smoothly.
    • Ride a stationary bicycle (with your spine flexed in a forward position) or walk on a treadmill with an incline. These are some of the most helpful aerobic exercises to try.

When to call a doctor

Call 911 anytime you think you may need emergency care. For example, call if:

  • You are unable to move a leg at all.

Call your doctor now or seek medical care right away if:

  • You have new or worse symptoms in your legs or buttocks. Symptoms may include:
    • Numbness or tingling.
    • Weakness.
    • Pain.
  • You lose bladder or bowel control.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have a fever, lose weight, or don't feel well.
  • You are not getting better as expected.