Spinal stenosis

This condition makes the amount of space within the spine smaller. That can squeeze the nerves that travel through the spine. Surgery sometimes is needed.

Update Date: 19.08.2026

Overview
Symptoms
Causes
Risk factors
Diagnosis
Treatment
Lifestyle and home remedies
Alternative medicine
Preparing for an appointment

Overview

Spinal stenosis happens when the space inside the spine is too small. This can put pressure on the spinal cord and nerves in the spine. Spinal stenosis happens most often in the lower back and in the neck.

Some people with spinal stenosis have no symptoms. Others may have pain, tingling, numbness and muscle weakness. Symptoms may get worse over time.

Spinal stenosis becomes more common with age. The condition often is linked to wear-and-tear damage in the spine due to arthritis. Medicines and physical therapy may help ease symptoms of spinal stenosis. People who have serious spinal stenosis may need surgery.

Surgery can make more space inside the spine. That can ease the symptoms caused by pressure on the spinal cord or nerves. But surgery can't cure arthritis, so arthritis pain in the spine may last even after surgery.

Symptoms

In many people, spinal stenosis doesn't cause any symptoms. When symptoms do happen, they typically start slowly, and they can get worse over time. Symptoms depend on which part of the spine is affected by spinal stenosis.

In the lower back

Spinal stenosis in the lower back can cause pain or cramping in one or both legs. This typically happens when standing for a long time or walking. Symptoms get better when bending forward or sitting. Spinal stenosis in the lower back also may cause back pain. Rarely, spinal stenosis in the lower back may cause bladder or bowel changes.

In the neck

Spinal stenosis in the neck can cause:

  • Numbness.
  • Tingling or weakness in an arm, hand, leg or foot.
  • Trouble with walking and balance.
  • Trouble with fine motor skills, such as writing, tying shoelaces, or using a knife and fork.
  • Neck pain.
  • Bladder or bowel changes.

Causes

The spine is made of spinal bones stacked in a column from the skull to the tailbone. They protect the spinal cord and nerves. The spinal cord runs through an opening in the middle of the spine called the spinal canal.

Some people are born with a small spinal canal. But most spinal stenosis happens when something shrinks the amount of open space within the spine. Causes of spinal stenosis include:

  • Bone spurs. Wear-and-tear damage from arthritis can cause extra bone to grow on the spine. This makes bone spurs that can push into the spinal canal.
  • Herniated disks. Disks are soft cushions that act as shock absorbers between the spinal bones. If part of the disk's soft inner material leaks out, it can press on the spinal cord or nerves.
  • Thick ligaments. The strong cords that help hold the bones of the spine together can become stiff and thick over time. Thick ligaments can push into the spinal canal.
  • Spinal injuries. Car accidents and other trauma can cause spinal bones to break or move out of place. Swelling of nearby tissue right after back surgery also can put pressure on the spinal cord or nerves.
  • Tumors. Rarely, tumors can form inside the spinal canal.

Herniated disk and bone spurs on spine

As the spine ages, bone spurs or herniated disks are more likely to form. These conditions can shrink the amount of space available for the spinal cord and nerves in the spine.

Risk factors

Age is the main risk factor for spinal stenosis. Most people who have spinal stenosis are older than 50. Younger people might be at higher risk of spinal stenosis if they develop arthritis at an early age or if they have other conditions that affect the spine.

Diagnosis

To diagnose spinal stenosis, your healthcare professional will likely ask about your symptoms and medical history. You may have a physical exam, and you might need imaging tests.

Imaging tests

These tests may include:

  • X-rays. An X-ray of the back can show bone changes that may be making the open space within the spinal canal smaller.
  • Magnetic resonance imaging (MRI). An MRI uses a powerful magnet and radio waves to make detailed images of hard and soft tissue. The test can show damage to the disks and ligaments in the spine. It also can show whether tumors are present.
  • Computerized tomography (CT). If you can't have an MRI, you may need a CT scan. This test combines X-ray images taken from many different angles. In a CT myelogram, contrast material is placed into the spinal canal. The contrast material can help the healthcare team find herniated disks, bone spurs and tumors on the images.

Treatment

Depending on symptoms, treatment for spinal stenosis may include medicines, physical therapy and surgery.

Medicines

Medicines that can be helpful for spinal stenosis include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). If pain relievers you can buy without a prescription don't offer enough relief, prescription NSAIDs might be helpful.
  • Antidepressants. Nightly doses of tricyclic antidepressants, such as amitriptyline, can help ease chronic pain.
  • Anti-seizure medicine. Some anti-seizure medicines, such as gabapentin (Neurontin, Gralise, others), are used to ease pain caused by damaged nerves.
  • Opioids. Opioid medicines such as oxycodone (Oxycontin, Roxicodone, others) should be used sparingly. They can be habit-forming.

Steroid shots

Nerve roots may become irritated and swollen where they are being pinched due to spinal stenosis. Sometimes a steroid medicine is put into the space around a pinched nerve to ease swelling and pain.

But steroid shots might not be the best choice for spinal stenosis. Some studies have shown that combined shots of steroids and a numbing medicine ease back pain no better than shots of numbing medicine alone.

This is important because steroids occasionally can cause serious side effects, and there is a limit to how much steroid medicine you can get. That's why there's often a waiting period of many months between steroid shots.

Physical therapy

Physical therapy involves exercises that may help:

  • Build strength and endurance.
  • Keep the spine flexible and stable.
  • Improve balance.

Surgery

Surgeries that can make more space within the spinal canal include:

  • Laminectomy. This surgery takes out the back part of a spinal bone. That part of the bone is called the lamina. The surgery eases pressure on the nerves by making more space around them. Sometimes, the bone may need to be linked to nearby spinal bones with metal hardware and a bone graft in a fusion procedure.
  • Laminotomy. This surgery takes out only part of the lamina. The surgeon makes a hole just big enough to ease pressure in a specific spot.
  • Laminoplasty. This surgery is done on the spinal bones in the neck. It makes the space within the spinal canal bigger by putting a hinge on the lamina. Metal hardware is used to bridge the gap in the open part of the spine.

These surgeries often help ease spinal stenosis symptoms. But sometimes symptoms stay the same or get worse after surgery. Surgical risks include:

  • Infection.
  • Blood clot in a leg vein.
  • A tear in the membrane that covers the spinal cord.

Laminectomy

A lumbar laminectomy involves taking out the back part of a spinal bone, called the lamina, in the lower back to make more room in the spinal canal.

Cervical laminectomy

A cervical laminectomy involves taking out the back part of a spinal bone, called the lamina, in the neck to make more room in the spinal canal.

Laminotomy

A laminotomy takes out only some of the back part of a spinal bone, called the lamina. The procedure makes a hole just big enough to ease the pressure in a specific spot. While shown here on the neck, the surgery also can be done in the lower spine.

Laminoplasty

Laminoplasty is done on the spinal bones in the neck. It makes more space in the spinal canal by putting a hinge on the back part of a spinal bone, called the lamina. Metal hardware is used to bridge the gap in the open part of the spine.

Lifestyle and home remedies

Your healthcare professional may suggest:

  • Pain relievers. Medicines you can buy without a prescription may help ease pain and swelling. These medicines include aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) and acetaminophen (Tylenol, others).
  • Weight loss. Losing extra weight may ease pain by taking some stress off the lower back.
  • Exercise. Stretching and strengthening exercises may help ease symptoms. Talk with your healthcare team about exercises that are safe to do at home.
  • Walking aids. Using a cane or walker can help with stability. This also may ease pain by allowing you to bend forward while walking.

Alternative medicine

Integrative medicine and alternative therapies may be used with other treatments to help you cope with spinal stenosis pain. Examples include:

  • Acupuncture.
  • Massage therapy.
  • Chiropractic treatment.

Preparing for an appointment

You're likely to start by seeing your primary healthcare professional. But you might be referred to a doctor who specializes in conditions that affect the nervous system. Depending on how serious your symptoms are, you also may need to see a surgeon who specializes in spinal surgery. That surgeon may be a neurosurgeon or an orthopedic surgeon.

What you can do

When you make the appointment, ask if there's anything you need to do before your appointment, such as not eating or drinking for a certain amount of time. Make a list of:

  • Your symptoms, including any that don't seem related to the reason for your appointment.
  • Key personal information, including major stresses, recent life changes and family medical history.
  • All medicines, vitamins or other supplements you take, including the doses.
  • Questions to ask your healthcare professional.

Take a family member or friend along, if possible, to help you remember the information you're given.

For spinal stenosis, some basic questions to ask your healthcare professional include:

  • What is the most likely cause of my symptoms?
  • What tests do I need?
  • What treatment do you recommend?
  • If you're recommending medicines, what are the possible side effects?
  • I have other medical conditions. How can I best manage them together?
  • How long will I need treatment?
  • What self-care measures should I try?

What to expect from your doctor

Your healthcare professional may ask you questions, including:

  • When did your symptoms start?
  • Have the symptoms gotten worse over time?
  • Do you have pain? Where is it?
  • Does any position ease the pain or make it worse?
  • Do you have any weakness, numbness or tingling?
  • Do you feel clumsier lately?
  • Have you had any bowel or bladder changes?
  • Have your parents or siblings ever had similar symptoms?
  • What spine surgeries, shots or other treatment have you had before?

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