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What You Should Know About a Diagnosis of Spinal Stenosis

Early intervention helps you manage the spinal pain that pops up late in life.


It’s no secret that aging has its health challenges. We move a little slower, feel more aches and pains and face higher risks of disease.

Wrinkles, gray hairs and other physical signs of aging are easy to spot. Others sneak up on us, coming on gradually as the years go on.

Spinal stenosis is one of those things.

What is spinal stenosis?

Stenosis is a medical term that simply means “narrowing.” It can happen to many parts of your body, including your heart and your arteries. Spinal stenosis is the narrowing of the bones, joints and canal that make up your spine.

“Spinal stenosis is a kind of age-related wear and tear on the spine. There can be narrowing on the spinal cord itself or on the nerves that exit the spine,” says Emily Burns, ARNP, a back pain specialist at The Iowa Clinic Spine Center.

As your spine narrows, there’s less space. The 26 vertebrae that make up your spine get compressed, which can irritate, pinch or put pressure on your spinal cord or nerves.

How bad is it, doc?

“It’s a serious condition,” Burns says. “It can cause multiple symptoms, including pain, numbness, tingling and even weakness.”

But it likely won’t be bad at first. Spinal stenosis generally develops slowly. You may not have any symptoms, even if there are clear signs of stenosis on an X-ray or MRI.

Then the pain starts. It might feel like lower back pain or sciatica. Over time, it progresses to numbness and tingling. The worst cases cause weakness.

Depending on where along your spine the stenosis occurs, these symptoms may not be contained to your back or travel down to your legs as you’d expect with sciatica. The pain, numbness, tingling and weakness can show up in your neck, arms, hands or feet too.

These symptoms are concerning enough to cause most people to consult a doctor. But the slow progression of symptoms may delay your motivation to seek treatment. A good way to tell if spinal stenosis is a problem is with the “shopping cart test.” If you find leaning on the shopping cart offers relief as you walk through the grocery aisles, that’s often a sign of spinal stenosis in the lower back.

Does everyone’s spine narrow as they age?

Age is the biggest risk factor for spinal stenosis. Because as you get older, your bones and ligaments grow thicker and stiffer. They might also grow bone spurs as a result of osteoarthritis. If you have excessive inflammation due to arthritis, that also shrinks the space in your spine.

“We generally see worse symptoms in patients over the age of 70. That would be kind of an average,” Burns says.

That’s just for the worst symptoms. The initial signs may show up much earlier. Spinal stenosis is most common in people over the age of 65 and may start as early as age 50.

But getting older doesn’t necessarily mean you’ll develop spinal stenosis. Even if your spine narrows in one or more places, it may not be enough to affect the spinal cord or nerves and cause symptoms.

Can I prevent spinal stenosis?

Nobody beats Father Time. But you can stave off the onset of age-related issues like spinal stenosis. The key, Burns says, is similar to other prescriptions for disease prevention.

“Try to live an active, healthy lifestyle. Make sure your weight is within a healthy BMI. Really, that’s it.”

Staying active as you age may require you to reduce the wear and tear on your body during exercise. Burns recommends low-impact activities like swimming or biking to keep yourself — and your spine — in good health.

“Swimming is a great exercise for your spine. You’re weightless in the water so it takes all the pressure off. You also use your whole spine so it works the whole back,” she says. “Biking is another one but any low-impact activity is good for your back.”

Even if you’re healthy and active, it’s important to seek treatment as soon as you experience back pain or other symptoms. Many people put off a visit, fearing that spine pain means spinal surgery. That’s one of the biggest misconceptions about spinal stenosis, Burns says.

“We like to start with conservative treatment and avoid surgery, if possible. There are a lot of other things we can do before it comes to that,” she says. “Physical therapy can help stretch and strengthen the muscles around the spine and in the low back and core. Anti-inflammatories help reduce inflammation in the body, helping to keep pain under control. And then steroid injections into the spine helps provide anti-inflammation into the nerve itself.”

But the longer you wait to seek help, the more likely you will need surgery to release the pressure on your nerves and relieve your symptoms. Catch spinal stenosis early and you can still prevent it from progressing.

“We want you to come in and be seen when it hurts. That’s the best time to manage it,” Burns says. “At the Spine Center, we offer same-day appointments so you can get treatment started as soon as possible.”

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