Central Canal Stenosis Symptoms

Spinal stenosis is a narrowing in the passageways in the spine.
Stenosis is a general term that means narrowing. Spinal stenosis is a narrowing in the passageways in the spine through which nerves and the spinal cord travel. (c) ADAM

Central spinal stenosis -  a condition that is most often related to the aging process -  is characterized by a progressive decrease in the diameter of your central canal. This decrease is more simply termed "narrowing."  (Stenosis is a general medical term that means narrowing.)

The problem is the spinal canal is home to your spinal cord, which is a part of the central nervous system.  As a major structure of the central nervous system, the cord consists of very sensitive tissue that is responsible for relaying messages of feeling and function throughout all areas of your body  

CENTRAL CANAL SYMPTOMS-HOW THEY HAPPEN

When the diameter of the canal  is narrowed, the result may be spinal cord compression.  This can lead to a number of symptoms that we'll discuss below, including pain, weakness, numbness and cramping, as well as others.  

Related:  Neurogenic Claudication

Dr. Sergio Gonzalez-Arias, medical director of Baptist Health Neuroscience Center in Miami, Florida comments that spinal cord compression can impair your functioning in a significant way.

Experts often refer to central canal stenosis as the “degenerative cascade,"  Gonzalez-Arias explains.  "The degenerative cascade is a phenomenon that can lead to thickening and roughening of the usually smooth surface of the bones, as well as loss of intervertebral disc height, and thickening of  soft tissues, such as the ligamentum flavum."  (The ligamentum flavum is a yellow ligament around the spinal canal and around the exiting nerves)  

Related:  Spinal LIgaments

Gonzalez-Arias says that when the ligamentum flavum thickens, it creates a constriction around the girth of the spinal canal that is analogous to a napkin ring around a napkin.  This constriction, in turn, may lead to compression of the nerves located within the canal as well as nerves at the level of the compression that exit the side of the spine.

DEALING WITH YOUR SYMPTOMS

So what does that mean to you?  Gonzales-Arias asserts the degenerative cascade may lead to the development of a constellation of symptoms, including, as mentioned above, numbness and weakness, but also clumsiness in one or multiple limbs, and, in severe cases, bladder and/or bowel dysfunction.

"When symptoms present, they most often are in the form of pain in the back, with or without weakness, numbness and/or cramping of one or both legs.  These symptoms are usually associated with prolonged walking or standing, and relieved by sitting and/or leaning forward," he informs me.

When you stand, he continues, your spine assumes an extended (think of an extension as arching your back) position, which further closes the spinal canal.  By contrast, when you sit, your spine goes into flexion, which opens the canal and therefore helps relieve the pain, he says.

Dr. John Toerge, an osteopathic physician, is a professor of medicine at Georgetown University and  the Medical Director of the Musculoskeletal Institute at the National Rehabilitation Hospital in Washington, D.C.

 While he agrees with Gonzalez-Arias's assessment of central canal stenosis symptoms, he says the inability to walk for longer distances without taking rests is the main symptom of this condition. If you have central canal stenosis, he warns, you may develop leg or back pain when walking, and you may find you need a few minutes of sitting in order to let your symptoms subside.  Toerge adds that sometimes people feel better walking behind a shopping cart or similar object. He comments that even a light touch on the shopping cart is enough to diminish the leg and/or back pain.

Gonzalez-Arias agrees, saying that patients often report that using a shopping cart makes it easier to walk.  He adds that patients also report over time the distance they are able to walk without pain tends to decrease.

The good news is there is something you can do to help alleviate pain and improve your daily functioning.  Physical therapy that teaches you how to strengthen your core and align your body may help diminish your symptoms, Toerge offers.

Sources:

Email Interview. Gonzalzs-Arias, Sergio M.D., Medical Director, Baptist Health Neuroscience Center, Miami, Florida. January 2014.

Email Interview. Toerge, J. DO, Medical Director Musculoskeletal Institute National Rehabilitation Hospital, Washington, DC.  January 2014.

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