Central Canal Stenosis Symptoms and Causes

Depiction of disc herniation causing central canal stenosis
Depiction of disc herniation causing central canal stenosis. cliparea


Central canal stenosis occurs when the passageway (called the spinal canal) that runs the length of the spinal column — and houses the the highly sensitive spinal cord — narrows. Most of the time, central canal stenosis is an age and/or arthritis related condition. This condition is progressive in nature.  

The Spinal Canal

Simply stated, the spinal canal is a hole down the center of your vertebral column.

Your spinal cord is located inside this hole. The spinal cord is a very key part of the central nervous system, which is comprised only of the "cord", as it is often called for short, and the brain.

As an aside, you also have a peripheral nervous system which is comprised of the nerves that branch off from the cord. These nerves exit the spine from an area on the side of the spinal column known as the intervertebral foramen, and subsequently proceed to all areas of your body. Essentially, the job of the peripheral nerves is to detect and relay sensations (temperature, pain, joint and body position and more), as well as to communicate movement impulses from your central nervous to your muscles. As you can see, the peripheral and central nervous systems relate, but are considered separate entities, as well.

Distinguishing Between the Spinal Canal and the Spinal Cord

Just so you're completely clear, let's distinguish the spinal canal from the spinal cord.

 

"The spine is the structural element and the spinal cord is the electrical and conductive portion of the system," says Dr. John Toerge, osteopath and professor of medicine at Georgetown University. Toerge is also the Medical Director of the Musculoskeletal Institute at the national Rehabilitation Hospital in Washington, D.C.

In other words, Toerge continues, "the canal is made of bone and supports the body, and it supports the motion of the spine. The spinal cord, on the other hand, provides the means of transmitting the impulses from the brain and other areas of the nervous system to the rest of the body."

Along with the "cord," the spinal canal houses blood vessels, fat and your spinal nerve roots.

Toerge further clarifies the functions of each structure by saying that the two generally work independently of one another, except when the canal becomes narrowed, i.e., in cases of central canal stenosis. 

The narrowing may impinge on the nervous elements of the cord, and it's at that point when the diagnosis of central canal stenosis is made, he adds. 

Narrowing in the spinal canal compresses the spinal cord and the spinal nerve roots, says Dr. Judith Glaser, a  physiatrist and acupuncturist practicing in New Hyde Park, New York.

And according to Dr. Sergio Gonzalez-Arias, medical director of Baptist Health Neuroscience Center in Miami, Florida, a compressed cord may cause any number of symptoms including (but not limited to) pain, weakness, numbness, clumsiness, and possibly bowel and/or bladder problems.

A classic symptom, he says, is neurogenic claudication. Neurogenic claudication is a cramping that may be associated with prolonged walking or standing.

What Causes the Spinal Canal to Narrow?

As mentioned above, arthritis of the spine is often at the root of central canal stenosis. Arthritis may develop on the spinal nerve roots and in the canal, Toerge clarifies. 

When arthritis affects the spinal nerve roots, it's called neuroformaninal stenosis.

But genetics may play a role, as well.  In other words, certain people are simply born with narrow spinal canals. "Some individuals have a small canal and a large spinal cord or a large canal and small spinal cord (the latter is the better scenario)," Toerge continues.

Not only that, but a wide variety of differences in the size of your spinal canal relative to the size of your spinal cord are possible. Toerge informs me that these differences greatly determine the issues people face with their central canal stenosis diagnosis. 

Glaser adds tumor to the list of causes of central canal stenosis, stating that while they are less common, they still sometimes underlie this condition.

Disc problems can also cause spinal canal narrowing, including herniations and loss of disc height.  

But living a sedentary life is the highest risk of all, Toerge concludes. This is because you need to use your muscles regularly in order to stay mobile and functional. If your sedentary way of life leads to a loss of physical function, "the outcome can have serious consequences."

 

Sources:

Email Interview. Glaser, J. DO, LAC, Restorative Medicine in New Hyde Park, NY January 2014.

Email Interview. Gonzalez-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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