1. How Canal Stenosis Develops

2. What is canal stenosis? Canal stenosis involves the
narrowing of the spinal canal, which is the passageway
through which the spinal cord runs. The canal itself,
which is sometimes called the vertebral cavity, is formed
by stacked, ring-like bones called vertebrae. There are a
variety of reasons that a section of the spinal canal could
become narrowed. Usually it involves an anatomical
abnormality like a herniated disc, bulging disc, bone spur,
or a slipped vertebra (spondylolisthesis). Degeneration
related to the aging process is the primary reason that
these conditions can develop, though injuries, genetics,
repetitive spinal stress, and poor posture are among
other common causes of canal stenosis.

3. Canal Stenosis vs. Foraminal Stenosis
Although the conditions are similar, canal stenosis should be differentiated from foraminal stenosis, which
is the narrowing of a vertebral foramen. The vertebral foramina are openings on either side of each
vertebra through which spinal nerve roots pass as they exit the spinal cord and branch off toward other
areas of the body. The foramina can become narrowed due to the same conditions that can affect the
central canal.
Canal stenosis and foraminal stenosis are generally not painful conditions in and of themselves, but if these
passageways become narrowed to the point that a neural structure is compressed, symptoms can arise.
Canal stenosis is more likely to cause compression of the spinal cord, which may lead to myelopathic
symptoms like:
• Weakness or spasticity in the muscles of the back, neck, and/or extremities
• Sensory problems
• Problems with balance or gait
• Bladder or bowel dysfunction, which should be treated as medical emergency
Foraminal stenosis is more likely to cause compression of a spinal nerve root, which may lead to
radiculopathic symptoms like:
• Tingling or a pins-and-needles sensation in the back, neck, and or/extremities
• Shooting pain, or pain that feels warm or electric
• Muscle weakness or cramping

4. Conservative Treatments for
Canal Stenosis
Once you receive a professional
diagnosis of canal stenosis, your
doctor will likely prescribe a regimen
of nonsurgical treatments to help
relieve symptoms associated with
neural compression. Common conservative approaches to
pain relief include non-steroidal anti-inflammatory drugs,
hot/cold compresses, physical therapy, stretching, low-
impact exercise, corticosteroid injections, and
transcutaneous electrical nerve stimulation, among others.

5. Alternative & Complementary
Medicine for Canal Stenosis
Some patients have been able to find relief from their canal
stenosis symptoms with the use of complementary and alternative
medicine (CAM). This involves products and practices aimed at
health and wellbeing that are not typically part of conventional, or
standard, medicine. While some forms of CAM are aimed more at
preventing the onset of certain health conditions, there are also
many therapies that may be able to help alleviate the pain
associated with a chronic condition like canal stenosis. Examples
may include yoga, massage, acupuncture, and herbal supplements.
Be sure to consult with your primary care physician or a spine
specialist before integrating or replacing any aspect of your
prescribed treatment regimen with complementary or alternative
therapies.

6. Surgery for Canal Stenosis
For the majority of people with symptomatic canal stenosis, surgery will not become a
consideration. Conservative treatments are usually effective at mitigating the
symptoms enough that an individual can remain active and maintain a high quality of
life. If, however, several weeks or months of conservative treatments do not help your
symptoms to abate, surgery may become an option. There are generally two types of
surgery available for patients with canal stenosis: endoscopic surgery and open spine
surgery. Endoscopic surgery is a minimally invasive, outpatient procedure that involves
less risk of complications, but not all patients will be candidates for this type of
procedure.
If you are considering surgery for canal stenosis, foraminal stenosis, or any other kind
of degenerative spine condition, the important thing to keep in mind is that elective
surgery should only be a last resort option. Speak with a variety of spine specialists
about whether surgery is really your only hope for meaningful pain relief, and always
ask if there are additional conservative treatments you can try.