While spinal narrowing is common with aging, severe spinal stenosis (narrowing of the spinal canal) typically becomes symptomatic and diagnosed in adults over 50, especially after age 60, due to degenerative changes like osteoarthritis, with the average age for seeking treatment often cited between 62 and 69. It's a degenerative condition, so while it can affect younger people (30-50) with injuries or congenital issues, it's most prevalent in older adults, making it a leading reason for spinal surgery in those over 65.
Spinal stenosis is common because osteoarthritis begins to cause changes in most people's spine by age 50. That's why most people who develop symptoms of spinal stenosis are 50 or older.
Spinal issues, especially in the cervical or thoracic regions, can sometimes cause back pain and nausea. Herniated discs, spinal stenosis, or compressed nerves in the spine can affect nearby structures, leading to discomfort in the back and digestive symptoms.
Spinal stenosis is fairly common. Degenerative spinal changes affect up to 95% of people by the age of 50. Spinal stenosis is one of those changes. For people over 65 undergoing spine surgery, lumbar spinal stenosis is the most common diagnosis.
Spinal stenosis does not shorten life, but it can lead to disability without treatment. A follow-up study of elderly patients who underwent lumbar spine surgery found that patients 60-70 years old had an 87.8 percent survival rate of 10 years.
If an individual's condition progresses to the final stages of spinal stenosis, they may experience significant and sometimes permanent changes in their ability to move or care for themselves. These may include chronic pain, numbness, weakness, and in the most severe instances, loss of bowel or bladder control.
Rest assured, most spinal stenosis patients recover without the need for surgery. But, if you're suffering from a severe form of this spinal condition, know that there are many innovative treatment options at your fingertips.
The truth is, spinal stenosis typically progresses slowly over time—often taking years to cause significant symptoms. In many cases, the condition may remain stable or worsen only very gradually.
The spine protects the spinal cord and works as the main support for the body. Over many years, it undergoes wear and tear. Medical studies reveal that around 80% of people above 70 display stenotic changes on MRIs, although many do not show symptoms.
Severe spinal stenosis L4-L5 can lead to life-changing symptoms, making it important to recognize its warning signs early. The hallmark signs include lower back pain, radiating discomfort into the legs, and increasing difficulty with daily activities.
Spinal stenosis happens most often in the lower back and the neck. Some people with spinal stenosis have no symptoms. Others may experience pain, tingling, numbness and muscle weakness. Symptoms can get worse over time.
There may also be a reduction or complete loss of bowel and/or bladder control. This condition, called cauda equina syndrome, is a medical emergency and requires urgent treatment to preserve leg function and restore bowel and/or bladder function.
Spinal headache symptoms include: Dull, throbbing pain that varies in intensity from mild to very severe. Pain that typically gets worse when you sit up or stand and decreases or goes away when you lie down.
The heritability estimate (h2) for qualitatively assessed central lumbar spinal stenosis on MRI was 67% (95%CI: 56.8-74.5). The broad sense heritability estimate for dural sac cross-sectional area was 81.2% (95%CI: 74.5 – 86.1%), with a similar magnitude of genetic influences across lumbar levels (h2=72.4-75.6).
This condition is caused by damage to the discs between your spine's third and fourth lumbar vertebrae (L3 and L4). Symptoms of a L3-L4 disc herniation can include pain, numbness, tingling, and weakness in the lower back and legs.
What is the most successful treatment for spinal stenosis? Surgical decompression is recognized as an effective treatment for spinal stenosis. This procedure carefully removes enough bone and soft tissue to relieve pressure while preserving enough to maintain stability.
Individuals aged 80 and older experience improvement in self-reported outcomes similar to those of younger individuals after decompressive surgery for LSS.
Corticosteroid Injections
A corticosteroid injection, also called an epidural injection, involves placing medication directly into the epidural space—an area inside the spinal canal between the vertebrae and the fluid-filled sac surrounding the nerve roots and spinal cord.
If common pain relievers don't provide enough relief, prescription NSAIDs might be helpful. Antidepressants. Nightly doses of tricyclic antidepressants, such as amitriptyline, can help ease chronic pain.
Spinal stenosis can't be cured but responds to treatment.
"Unfortunately, nothing can stop the progression of spinal stenosis, since it is due to daily wear and tear," said Dr. Hennenhoefer. "The symptoms of spinal stenosis typically respond to conservative treatments, including physical therapy and injections."
Tumors of the spine are abnormal growths of soft tissue that may affect the spinal canal directly by causing inflammation or growth of tissue into the spinal canal. This can narrow the space and cause bone changes, leading to spinal stenosis.
In certain situations, it may be best to sleep in the fetal position. That is, with your knees tucked up to your chest and your arms wrapped around them. This may help people who have suffered spinal stenosis or a herniated disc. The benefit of this position is that it opens up space between your bones.
You may want to have surgery if you have tried other treatments for a few months and your pain or other symptoms are still so bad that you can't do your normal activities. Back surgery has some risks, including infection, nerve damage, and the chance that the surgery won't relieve your symptoms.
The best muscle relaxer for spinal stenosis can vary from patient to patient. However, the best options include baclofen, cyclobenzaprine, and methocarbamol. Baclofen is an antispastic drug that's widely used to treat muscle spasms in spinal cord conditions, including lumbar spinal stenosis.
A new approach to non-surgical treatment for lumbar spinal stenosis called the mild® procedure (Minimally Invasive Lumbar Decompression) can decompress and relieve nerve pressure without implants or structural changes to the spine.