Spine Care
Spinal Stenosis
A narrowing of the spaces within the spine that places pressure on the nerves travelling through it — most often in the lower back or the neck.
What It Is
Understanding Spinal Stenosis
Stenosis develops gradually over years, most commonly in the lower back (lumbar) or the neck (cervical). Many people have it on imaging yet feel nothing at all.
When symptoms do appear, they tend to worsen slowly. The pattern — and what relieves it — helps guide diagnosis and the right treatment plan.
Symptoms
How Stenosis Feels
- Lumbar stenosis — pain, numbness, or cramping in the legs when walking or standing (neurogenic claudication) that eases when sitting or leaning forward, with leg weakness and difficulty walking distances.
- Cervical stenosis — neck pain, numbness or tingling in the arms and hands, weakness, and balance problems; in severe cases, bladder or bowel dysfunction.
Causes
Why the Canal Narrows
- Degenerative changes (most common) — age-related bone spurs, thickened ligaments, and bulging discs that narrow the canal.
- Disc herniation — a bulging or ruptured disc adding to the narrowing.
- Thickened ligaments & bone spurs — the ligamentum flavum buckles inward; osteoarthritic overgrowth encroaches on the canal.
- Congenital narrowing, and less commonly trauma or tumours.
Diagnosis
How Spinal Stenosis Is Diagnosed
01
Clinical Examination
Walking ability, balance, reflexes, and strength. The “shopping-cart sign” — leaning forward for relief — is characteristic.
02
MRI Scan
The best study for visualising the spinal canal, nerves, and soft tissues — and the degree of narrowing.
03
CT & X-ray
CT details the bony structures when MRI is not possible; X-ray shows alignment, bone spurs, and disc-space narrowing.
Treatment · Step One
Non-Surgical Care First
Many people manage stenosis without surgery, especially in mild to moderate cases.
- Physiotherapy — core and back strengthening, flexibility, and mobility; flexion-based exercises often help.
- Medications — anti-inflammatories, nerve-pain medication, and muscle relaxants.
- Epidural steroid injections — reduce inflammation around the nerves, often giving weeks to months of relief.
- Activity & weight management — walking aids, rest breaks, and reducing load on the spine.
Treatment · When Needed
When Surgery Is Considered
Surgery is considered when conservative care fails, symptoms are severe, or there is progressive neurological decline.
- Laminectomy (decompression) — removing the lamina to create space for the nerves; the most common surgery for lumbar stenosis.
- Laminectomy with fusion — added when decompression alone would leave the spine unstable.
- Minimally invasive options — smaller incisions and faster recovery for suitable patients.
Reassurance
The aim is simple —
to keep you walking comfortably.
Red Flags
Seek Emergency Care
Go to an emergency department if you experience any of the following, which may indicate severe nerve compression:
- Loss of bladder or bowel control
- Severe or rapidly progressive weakness in the legs
- Numbness in the groin or inner thighs
- Sudden inability to walk
Get Started
Has Walking Become Difficult?
If leg pain or weakness is limiting how far you can walk, call +966 50 580 8852 to schedule an evaluation with Professor Al-Othman.
Related
Related Spine Conditions
Disc Prolapse
A herniated disc that can contribute to canal narrowing and nerve pressure.
Lumbar Fixation
Spinal fusion to stabilise the spine when decompression alone is not enough.