It is one of the most common diseases in spinal disorders, often occurring in the lower back area. It was first mentioned about 200 years ago.
How does it occur?
It is caused by degeneration of the spine. As age increases, the spine begins to degenerate, including degeneration of the intervertebral discs which collapse or bulge. The facet joints at the back of the spine enlarge, and there is thickening of the tissue in the spinal canal. All of these contribute to narrowing of the spinal canal. This condition results from age-related degeneration, with genetics and usage also playing a role.
What are the symptoms?
The spinal canal contains nerves that control muscle function and provide sensation to the skin areas served by those nerves. When the spinal canal narrows to a certain degree, the nerves inside are compressed, causing symptoms such as back pain or hip pain radiating down the leg, numbness, or weakness. Walking distances become limited due to leg pain, requiring rest. Some people may also have problems controlling bowel or bladder functions.
Who does it affect?
It is more common in people aged 50 and above, affecting both men and women equally. It is more frequently found in people who heavily use their spine, such as those who lift heavy objects or frequently bend and straighten. Other risk factors include genetics (family history), being overweight, and smoking. In younger people, it can sometimes be found in those with a congenitally narrow spinal canal, where even slight abnormalities can easily compress the nerves compared to normal individuals.
How is it diagnosed?
Diagnosis is based on compatible patient symptoms. Physical examination may reveal numbness or muscle weakness in the areas served by the affected nerves. General X-rays may show spinal degeneration and disc collapse. Some may also show spinal instability. MRI (Magnetic Resonance Imaging) is used to confirm the diagnosis, allowing visualization of the spinal canal and compressed nerves, as well as the severity and location of the compression.
Treatment of spinal canal stenosis
For patients with mild symptoms, it is recommended to adjust activity habits, avoid heavy lifting, lose weight, and strengthen back muscles. Medication and physical therapy can be used together. For those with severe symptoms, significant leg pain, very limited walking distance, and major interference with daily life, surgery is an effective treatment. Currently, various surgical methods are available depending on the suitability for each patient.
- Surgery to remove tissue and bone compressing the nerves, which can now be performed using a microscope or endoscope, resulting in small incisions, less injury, shorter hospital stays, and faster recovery.
- Surgery involving spinal instrumentation combined with removal of tissue and bone compressing the nerves, suitable for patients with severe back pain from degenerated or deformed joints, or spinal instability, along with leg pain. Accurate diagnosis relies on symptoms, physical examination, and imaging studies. Treatment aims to improve quality of life through activity modification, medication, physical therapy, and surgery, depending on the patient’s symptoms.
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Dr. Prusnai Prutthikul
Specialist Spine Surgeon
Phyathai 3 Hospital
