Frequently Asked Questions
Spinal Canal Stenosis
Stenosis is a medical word for narrowing, and in the case of the spine, refers to a narrowing of the spinal canal (the passage formed by the vertebrae) which is the space that the spinal cord runs down. The condition commonly affects people over the age of 60.
Conditions such as osteoarthritis (having less cartilage or shock absorbing material in the joints) and rheumatoid arthritis (inflamed joints) cause extra bone growth and swelling that can reduce the size of the spinal canal.
With age, the spinal canal becomes narrow and in some cases arthritic conditions cause the canal to become so narrow that the blood supply to the nerves in the spinal cord reduces. This may cause pain, numbness and weakness in both legs. However, many people who show signs of stenosis on X-ray or MRI have no symptoms at all.
Very rarely, vertebrae can move forward slightly on each other and this can cause the spinal canal to become narrow (a condition known as spondylolisthesis). Andre Agassi famously won Wimbledon with a spondylolisthesis!
Symptoms associated with spinal canal stenosis are usually better with sitting and worse with standing and walking. One hallmark is said to be the “shopping trolley sign” where symptoms are rapidly relieved by leaning forward as in the example of leaning onto the handles of a shopping trolley.
Your physio is trained to distinguish between spinal canal stenosis and other causes of low back pain and leg pain that require additional testing and treatment.
They will diagnose the condition after asking you a series of questions about your pain and examining your back. They might do some special tests to check the reflexes, sensation and strength of your legs.
Once a diagnosis of spinal canal stenosis is suspected, your physio can help you decide on how to manage the condition. Options might include self-management techniques, education, exercises or a combination of these. The management of spinal canal stenosis is similar to that of radicular pain in that it is recommended to have a trial of conservative treatment for at least six weeks prior to undergoing further tests or invasive treatment such as injections or surgery.