Whilst spinal narrowing may remain asymptomatic in some people in others there can be damaging long-term effects of spinal stenosis. Virtually everybody develops a degree of spinal stenosis as they age but some are predisposed to symptoms of this narrowing due to congenitally short pedicles, narrow foraminal spaces, or other condition affecting the natural structure of the spine. Without appropriate treatment for spinal stenosis, which may include back surgery, patients are more likely to develop nerve damage and even spinal cord damage with a variety of symptoms then possible.
Spinal Stenosis Symptoms
Early signs of spinal stenosis may include things such as intermittent pain and tingling in the arms and hands, pain in the neck or back, and pain or altered sensation when standing for prolonged periods of time or bending backwards as this reduces the spaces in the lumbar spine through which nerves pass. It can be difficult to distinguish neurogenic claudication from spinal stenosis from vascular claudication but it is important to make this distinction so as to apply appropriate treatment. One of the main long-term effects of spinal stenosis is reduced quality of life as nerve damage may result in chronic pain and/or disability that impacts the enjoyment of even everyday activities, as well as the ability to work, look after loved ones, and take care of oneself.
Spinal Stenosis Progression
Where spinal stenosis symptoms go unchecked the pain and tingling can lead to persistent paraesthesia, numbness, and weakness as muscles atrophy due to poor nerve innervation. Muscle fatigue is also possible as the pinched nerves may result in overactivity and muscle spasms or chronic contraction that can be painful and hard to relieve. Exercise may help to relieve tension in the muscles and strengthen the back and abdominals for improved posture but it can also increase fatigue and even exacerbate the spinal stenosis if done incorrectly. Over time, some patients find that endurance exercise becomes particularly problematic, if not inconceivable with lumbar spinal stenosis and sciatica. Pain medications may begin to lose their efficacy and the need for back surgery for spinal stenosis arises.
Acute Back Trauma and Spinal Stenosis
Unfortunately, spinal stenosis that is asymptomatic may suddenly become a problem due to a fall, accident, trauma, or other medical condition that causes inflammation or changes to the bone, such as osteoporosis. Vertebral compression fractures are more likely to occur in those with osteoporosis and where a degree of spinal stenosis already exists unrecognized it may be that an acute fracture has drastic long-term consequences in terms of nerve damage or spinal cord injury. Myelopathy may also occur as a result of whiplash, especially where cervical spinal stenosis is a pre-existing condition. Symptoms of myelopathy include loss of balance, bowel and bladder incontinence, chronic pain, and difficulties with fine motor function. Early symptoms of spinal stenosis usually only affect a single nerve or nerves at one spinal level but spinal cord compression can have long-term consequences for the whole of the body innervated by nerves below the site of injury.
Spreading Spinal Dysfunction
Other long-term effects of spinal stenosis include hypertrophy of the bones, ligaments, and connective tissue in the spine as it attempts to make itself more rigid to counter the loss of stability. This can then affect other parts of the spine, meaning that what starts out as lower back pain can become a more widespread chronic pain in the thoracic and cervical spinal regions. Identifying the cause of back pain early can help patients avoid or delay the potential long-term effects of spinal stenosis and possibly even avoid back surgery for spinal stenosis.