Symptoms of Spinal Stenosis

The various types of spinal stenosis produce very similar symptoms. In general, chronic pain with limitations on mobility are the most common symptoms associated with spinal stenosis. Pressure on the lower, or lumbar, part of the spinal cord or on nerve roots branching out from the lower back area may give rise to pain or numbness in the legs. Pressure on the upper, or cervical, part of the spinal cord (the neck area) may produce similar symptoms in the shoulders and arms.
The symptoms of spinal stenosis usually develop slowly over time and occur during certain activities or when the body assumes certain positions. The pain may come and go, as opposed to being continuous, and, at times may be relieved by lying down or sitting in a flexed forward position. This flexed position "opens up" the spinal column, enlarging the spaces between vertebrae at the back of the spine.
Pain in the legs when walking is a common symptom of lumbar spinal stenosis. Although occasionally this leg pain from spinal stenosis comes on acutely, it usually develops over several years. Numbness and tingling can accompany pain from lumbar spinal stenosis.
Pseudoclaudication is pain and discomfort in the buttocks, legs and feet due to narrowing of the spinal canal from spinal stenosis. In pseudoclaudication, the narrowing of the spinal canal compresses the nerves that control movement and sensation in the legs. It may also cause numbness and weakness in the legs.
People with more severe spinal stenosis may also experience abnormal bowel and bladder function and foot disorders. For example, cauda equina syndrome is a partial or complete loss of control of the bowel or bladder and sometimes sexual function.
The collection of nerves at the end of the spinal cord is known as the cauda equina, due to its resemblance to a horse's tail. The spinal cord ends at the upper portion of the lumbar (lower back) spine. The individual nerve roots at the end of the spinal cord that provide motor and sensory function to the legs and the bladder continue along in the spinal canal. The cauda equina is the continuation of these nerve roots in the lumbar region. These nerves send and receive messages to and from the lower limbs and pelvic organs.
Caudia equina syndrome most commonly results from a massive herniated disc in the lumbar region. A single excessive strain or injury may cause a herniated disc. However, disc material also degenerates naturally with age, and the ligaments that hold the discs in place begin to weaken. As this degeneration progresses, a relatively minor strain or twisting movement can cause a disc to rupture.
For more information: www.bonati.com/glossary/spinal_stenosis.html

Research and Outreach

Back neck problems are the number reason people seek medical attention, miss work, and file for disability. There are also more than 100 different symptoms that can result from a problem with the lumbar or cervical spine. For most people these symptoms are short-lived and acute. For others the symptoms may last for more than 3 months, classifying them as chronic pain.
Over the past 25 years we at The Bonati Institute have come to realize that there are two very important steps that anyone seeking medical attention for chronic pain from a lumbar or cervical spine problem should take. The first is research. There are dozens, if not hundreds, of treatment methods for spine prblems. They range from very conservative and non-invasive protocols like physical therapy and medication, to more aggressive invasive protocols like surgery.
One can imagine these many treatment options as existing along a continuum, with conservative non-invasive treatment being appropriate for persons whose onset of chronic pain is recent, and the more agressive and invasive treatments as being appropriate for persons whose onset of pain is further in the past.
Which treatment is best for your level of pain is partially in your hands. In this respect the internet has been a boon to "patient-directed" treatment, and presently to seek health information is the number one reason that people search on the net. Given that, we believe that it is critical that patients conduct as much research as possible on the Internet before seeking medical attention.
The second part to this is outreach. With any surgery, there is more to the protocl than just the "cutting". Any surgery or major medical procedure is only as effective as the array of services associated with it. Since the pre-operative and post-operative experience can be just as important as the surgical experience, we also encourage that you take the time to reach out to patients who have had the treatment for a "first-hand" impression.