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HEALTH ANSWERS

What is spinal stenosis, and how serious is it?

By Chelsea Conaboy
Globe Staff / January 9, 2012
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Q. What is spinal stenosis, and how serious is it? What are the treatment options?

A. Spinal stenosis is a narrowing of the spinal canal that can - but does not always - cause pain in the legs and other problems. It is typically the result of degenerative effects of aging.

Disks or joints in the back may bulge or vertebral bones grow spurs that push into the space where the spinal cord and nerves sit, compressing them.

The condition is not uncommon, said Dr. Carol Hartigan, a physiatrist in the Spine Center at New England Baptist Hospital. Researchers using imaging tests have found that as many as 30 percent of people over age 60 may have a narrowed canal, but not all experience symptoms, she said.

Especially when the narrowing happens slowly over time, the spinal cord and the nerves can adjust to the change, “like a tree that grows around a fence,’’ she said.

But some people will experience pain or weakness in the front or back of their legs, often more severe when they are standing or walking. Some, depending on the location of the stenosis, can have bowel and bladder problems.

Hartigan said people should see a doctor if the symptoms persist or if they are interfering with daily activities.

Staying physically fit is important to controlling symptoms of stenosis, Hartigan said. Often changing the position of the spine slightly can relieve pain enough to keep moving. Some who have trouble walking, might have an easier time riding a bike or even using a treadmill. Steroid injections can provide temporary relief for some, Hartigan said.

Severe cases may require surgery. But determining when that is most appropriate can be tricky, she said. For example, an imaging test might show a narrowed canal, but the leg weakness that person is experiencing might be the side effect of a cholesterol-lowering medication.

It’s important to assess the whole patient. “The spine is not always black and white,’’ Hartigan said.

Send health questions to globeanswers@gmail.com

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