Is spinal stenosis a serious condition?

Spinal stenosis is deadly serious. Lumbar spinal stenosis, such as Jon presented with, always gets worse. Not to scare you but left untreated spinal stenosis will cause paralysis of the legs, uncontrollable pain while standing and walking, numbness in the legs, inability to control your urine, and sexual dysfunction. Yikes.

In the old times before laminectomy surgery the result of spinal stenosis was that to end up paralyzed, in bed, incontinent of urine and with sexual dysfunction until you died of a urinary tract infection. Today we are not going to let that happen to you.

The truth is you cannot tell if you have spinal stenosis based just on how it feels. Clogging of the arteries also causes pain down your legs while walking. Bad veins can make your legs feel heavy. And herniated discs or bone spurs can cause pain down your leg. You may suspect you have spinal stenosis due to numbness, heaviness, or tingling in your feet when you walk that is relieved by bending over; however, you cannot feel spinal stenosis. You know if you have spinal stenosis by getting an MRI.



This is a sagittal cut through Jon’s low back taken with magnetic resonance imaging. In this cut the square blocks are the vertebral bones. The spinal fluid in the spinal canal is white. In the upper third of the picture look in the white spinal canal as you can appreciate “strings” running from top to bottom of the image. Those strings are the spinal nerve roots inside the spinal canal. About midway in the image, you see the white area narrow. This is spinal stenosis.



Spinal stenosis is caused by several factors. Discs form the floor of the spinal canal (left arrow), so a bulging disc means your floor is rising. The right arrow shows a ligament under the lamia bone. With age and wear ligament thickens. This means the roof is coming down. The spinal bones are also shifted slightly, trapping the spinal canal in between.



The term ‘stenosis’ refers to narrowing of the spinal canal which holds the spinal cord (cervical and thoracic). Think of the spinal canal as a room: the roof is the yellow ligament, the walls are the facet joints, and the floor is the disc space. Joints normally get bigger with age. (If you do not believe it, and you are over 40, look down at your knuckles.) The yellow ligament thickens with age because of wear and tear. And discs are famous for “bulging” (Herniated Disc). As a result of all these changes, with age and the roof coming down, the walls are moving and, and the floor is rising. It is not a surprise, then, that the spinal canal is getting smaller. Some people do not need to wait, they are born with a very narrow spinal canal. This condition is called congenital spinal stenosis. You know you have it if one of your parents and all your siblings have already had Laminectomy surgery. You can also develop narrowing of the spinal canal due to a shift in the vertebrae. The spine is a rigid ring. If one band moves forward on the other one, it creates a kink in between. This type of movement is called spondylolisthesis.

See the problem? Once it gets started, the processes of spinal narrowing can only get worse. Spinal stenosis is always progressive; it only gets worse. That means there is no stretching, exercise, injection, medicine, magic crème, or supplement that can help. Even sleeping in a pyramid with magnetic walls will not save you. We know because we have done studies.