How does spinal stenosis affect the body?

Symptoms range and vary according to where stenosis occurs within the spinal canal, as well as the severity of narrowing.

General symptoms of spinal stenosis are characterised in the following ways:

• Slow onset of symptom development (developing slowly as the body ages)
• Symptoms ‘come and go’ (i.e. are intermittent)
• Symptoms appear at their worst during specific activities (lumbar stenosis: when walking, or biking when holding the head upright) or bodily positions (i.e. standing upright or assuming a flexed forward position when standing or moving)
• Symptom relief during rest (i.e. sitting or lying down)

Symptoms of compression of the spinal cord (myelopathy):

• Problems with balance (which worsens) and walking (it may be difficult to pick up speed and legs may feel heavy)
• Frequent falls and dropping of objects
• Problems with grip and picking up small objects (such as coins) or fastening small buttons on clothing
• Incontinence (loss of bladder or bowel control)

Symptoms of spinal nerve root compression (radiculopathy):

• Sciatica (numbness, tingling and weakness along the sciatic nerve path)
• Pain (often described as ‘shooting pain’)

Common symptoms associated with lumbar spine stenosis:

• Pain (leg pain with walking – known as neurogenic or pseudo-claudication)
• ‘Foot drop’ (Painful and weakened legs may cause a ‘slapping of the feet on the ground’)
• Sciatica
• Cramping sensations in the legs and feet (especially when mobile, and finding some relief when at rest – sitting or lying down)

Relief from leg and lower back pain is normally achieved when a person stops walking and sits down for a few minutes. Sitting and flexing forward opens up the spinal canal and stretches the ligamentum flavum (spinal ligaments) which helps to provide some relief. Once an individual resumes an upright position however, symptoms of discomfort return.

Common symptoms associated with cervical spine stenosis:

• Myelopathy – including changes in handwriting or typing ability (subtle at first), placing a key in a door (locking and unlocking), and taking longer to dress each day
• Cramping sensations in the arms and hands
• Pain or soreness in the neck (with stiffness and a reduced range of motion) – sometimes with grinding sounds (known as crepitus)
• Intermittent or ‘shooting pain’ in the arms and legs (i.e. nerve pain – due to nerve roots becoming impinged)

Compression which occurs at the front (anterior) of the spinal cord typically causes motor dysfunction. Compression at the back (posterior) typically leads to sensory problems. It can happen that stenosis occurs in both the front and back portions of the spinal cord / canal.

Pain is often most noticeable in the arm for cervical spinal stenosis and progresses, developing more severe symptoms if not adequately treated, such as a loss of sensation and function in all limbs (paralysis / spinal cord impingement).

Common symptoms associated with thoracic spinal stenosis

Symptoms associated with thoracic spinal stenosis differ from the aforementioned types as the vertebrae in this part of the spine are attached to the ribs. Symptoms may include:

• Limited range of motion when moving the torso from side to side
• Pain in the back and ribs
• Radiating pain in the back and down the legs
• Leg aches
• Difficulty in walking
• Bladder dysfunction
• Issues with bowel function

When to seek medical attention

Severity of symptoms may vary. It is best to seek medical evaluation if pain is experienced in the neck, back or limbs, especially if accompanied by tingling or numbness. Such symptoms are not entirely specific to spinal stenosis alone, and could be as a result of various other medically related causes.

If symptoms have been experienced for at least 6 weeks, or if it is noted that symptoms are worsening, a medical examination is necessary in order to determine the potential cause, and in order to sufficiently treat it. Any severe symptoms, such as incontinence or signs of paralysis must be medically attended to as soon as possible.