Understanding Spinal Stenosis and How It Affects Walking
Spinal stenosis refers to the abnormal narrowing of spaces within the spine, which can put pressure on the spinal cord and nerves. One of the most common symptoms associated with spinal stenosis is difficulty walking due to pain, numbness or lack of coordination in the legs and feet.
What Causes Spinal Stenosis?
There are a few different causes of spinal stenosis. Some of the most common include:
- Aging - Wear and tear on the spine from everyday use can cause discs and bones to thicken over time.
- Arthritis - Osteoarthritis or rheumatoid arthritis can cause inflammation and bone overgrowth.
- Injury - Past injuries such as herniated discs or fractures can lead to abnormal bone growth.
- Congenital Defects - Some people are simply born with a narrow spinal canal.
How Does Spinal Stenosis Affect Your Ability to Walk?
When the spaces within the spine begin to narrow, it can impinge on the spinal cord, along with the nerves branching off it. The narrowing typically occurs gradually over time. As it worsens, symptoms often include:
- Weakness or numbness in the legs and feet
- Tingling or prickling sensations
- Cramping in the legs, calves or buttocks
- Unsteady walking or impaired balance
- Pain when walking which is relieved when sitting down
These symptoms all relate to the compressed nerves no longer being able to properly communicate signals to the muscles, resulting in muscle weakness and coordination problems.
How is Spinal Stenosis Diagnosed?
If walking problems and other symptoms lead a doctor to suspect spinal stenosis, some common diagnostic tests include:
Imaging Tests
- X-ray - Helps identify bone changes from arthritis or injuries.
- MRI - Provides clear images of soft tissues, nerves, discs.
- CT Scan - Detailed images of bone that can detect subtle changes.
- Myelogram - Contrast dye used to outline the spinal canal.
Physical Examination
Testing muscle strength, reflexes and sensory abilities in the arms and legs can help determine affected nerves.
Treadmill Test
Walking on a treadmill while symptoms are monitored helps clearly correlate difficulty walking with spinal stenosis.
Treatments for Walking Impairment from Spinal Stenosis
Treating spinal stenosis often starts conservatively with non-surgical options. When symptoms persist and walking remains severely impacted, surgery may be recommended.
Medication Options
Medications that may help alleviate inflammation and pain associated with walking difficulty include:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Anti-seizure medications
- Antidepressants
- Steroid injections
Physical Therapy
Working with a physical therapist can help spinal stenosis patients in many ways. Goals include building supporting muscle strength, improving flexibility and balance, and learning proper body mechanics for everyday activities like walking.
Using Assistive Devices
Tools like canes, walkers, braces and orthopedic shoes provide added support and stability for those struggling with walking due to spinal stenosis symptoms. Proper technique and safety should be addressed with a medical professional when using assistive devices.
Surgery Options
When walking ability continues to decline and surgical criteria is met, the following methods help decompress the spinal cord and relieve pressure on nerves:
- Laminectomy - Removing the lamina to create more space.
- Foraminotomy - Widening spaces where nerves branch out.
- Discectomy or Fusion - Removing or stabilizing discs.
Surgery has been proven successful for significantly improving walking ability in a majority of spinal stenosis patients when nonsurgical options do not adequately help.
Preventing Progression of Spinal Stenosis
While some underlying causes of spinal stenosis like congenital defect can't be prevented, there are still things you can do to help avoid progression including:
Daily Exercise
Low impact activities like walking, swimming and cycling keep the supporting muscles around the spine strong without added pressure and strain.
Maintain Proper Posture
When sitting or standing, be conscious of posture and body mechanics to avoid extra curvature or hunching of the spine which can exacerbate bone spur formation and disc issues over time.
Stretching and Flexibility
Gentle stretching, yoga and other flexibility boosting exercises allow for greater range of motion helping take pressure off nerve spaces within the spine.
Avoid Further Injury
Use caution to avoid falls or other impacts like whiplash that can lead to vertebral fractures, herniated discs, and other injuries known to increase risk of spinal stenosis.