The Causes of Spinal Stenosis

Causes of Spinal Stenosis

Stenosis is a condition of the spine brought on by nerve compression in the spinal column, usually caused by either injury, or more commonly, gradual degeneration as a result of the natural aging process. Until we can cure aging, the best deterrent for chronic pain in the late stages of life is to better understand the actions that lead to such deterioration.

About Spinal Stenosis

The area within the spinal column that protects the fragile spinal cord along with other nervous tissue is known as the spinal canal, and the condition of stenosis refers to a gradual tapering within the canal that encroaches on the nervous tissue. The process is typically slow, accumulation of multiple anatomical deteriorations. Those experiencing stenosis may be tempted to claim they are only feeling the standard effects of aging, like a stiffer back or radiating aches when woken up. To a certain degree these things are inevitable, but when they cross the line into numbness, tingling, chronic pain, or any number of symptoms related to nerve compression, a diagnosis of spinal stenosis is likely.

Avoiding stenosis as one ages can be difficult due to the vast potential causes. Several complex components have to function together perfectly for the spinal column to work in the way it was meant. The failure of even one of these parts could cause problems far beyond itself. A bone growth or tumor on a vertebrae could be harmless to the bone, but might press into the spinal canal, creating pressure on the nerves that would lead to a variety of undesirable symptoms. One such degeneration would be enough to cause stenosis, and several combined would only exacerbate the symptoms.

Spinal Deterioration

The neck and lower back regions are the most susceptible to degeneration due to their higher levels of motion and strain. The entire spine is at risk for all forms of degeneration though, such as bulging discs, herniated discs, arthritis between vertebrae, and spondylolisthesis, or instability in the spinal column. Stenosis can also be brought on by sprained muscles or ligaments in the back, spinal tumors, ligament calcification, or infection.

Spinal Stenosis Preventative Measures

Since one of the major contributing factors for stenosis is aging, which can’t be directly combated, the best way to avoid stenosis is to take care of your body as you age. Limit the activities that put extraneous stress on the back, and maintain a healthy body weight. Excess fat only increases the likelihood of problems with your heart, liver, lungs, and spine. Poor posture can also add unnecessary strain to specific areas of the spine, so be aware of how you position yourself when you walk, sit, or lie down. If you often participate in activities or sports that require intense ranges of motion you may be more susceptible to stenosis, so limiting those activities is recommended.

Stenosis Treatments

Those that develop stenosis despite their best efforts to avoid the causes should communicate closely with their doctor about the best course of treatment. Only a doctor can prescribe a regimen specific to your condition, and incorrect or incomplete treatment could worsen your state. Most physicians will attempt a noninvasive form of treatment as an initial option if applicable, in order to reduce the stress on the affected area. Medications such as anti-inflammatories are often included in a treatment course, combined with stretching, massage, application of heat, and other physical therapies.

Surgery Treatments

In rare occasions it will be necessary to surgically relieve the pressure from stenosis after failure of the noninvasive treatments. While this type of surgery is usually classified as elective, it can be the only source of relief for those experiencing extreme pain due to stenosis. Surgery aims to physically alleviate the pressure from within the spinal canal by removing the source of obstruction. Of the two types of surgeries available to address stenosis, endoscopic procedures are the least invasive and have the fastest recovery periods. The other surgical option, open spine surgery, is reserved for those patients who are ineligible for endoscopic procedures due to spinal instability. Speak with your doctor to learn more your treatment options.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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