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Johns Hopkins Health Alert

When Osteoarthritis Leads to Spinal Stenosis

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Osteoarthritis of the spine is a common cause of lower back pain and stiffness, and it can lead to a condition known as spinal stenosis. In spinal stenosis, degenerative changes in the spine cause the spinal canal to become narrower. This narrowing (stenosis) places pressure on the spinal cord and on the nerves branching out from it. This may lead to a range of symptoms, from vague numbness and weakness in the legs while standing and walking to, in the most severe cases, extreme pain and difficulties with bowel and bladder control.

Spinal stenosis can result from injury to the back, or, more often, as a normal part of the aging process. With age, the spongy disks between the vertebrae, which serve as a cushion, lose moisture and elasticity. Like a sponge, as the disks become harder and dry out, they shrink, which reduces the distance between the vertebrae above and below the disk. Sometimes the disks herniate (bulge out), pressing on nerves such as the sciatic nerve.

  • As the spine settles into a new position, the facet joints located at the back of each vertebra are forced to bear more weight. This increased pressure can lead to osteoarthritis and the deterioration of the facet joints.
  • As a result of the disk and facet joint deterioration, the vertebrae come even closer to one another and begin to rub together, eventually wearing away the cartilage covering their ends. As the cartilage deteriorates, the joints and supporting ligaments may thicken, narrowing the spinal canal.
  • Over time, the increased friction from the bones rubbing together may lead to the formation of overgrowths or bone spurs (osteophytes) at the facet joints as well as around the rims of the vertebrae. If these spurs grow inside the spinal canal, they can pinch the spinal cord as well as the sciatic nerve and other nerves that run through it.

What does it feel like? Spinal stenosis is associated with an array of symptoms, including:

  • Pain in the neck or back
  • Pain, weakness, numbness or cramping in the legs, back or buttocks
  • Shooting pain down the back of one leg (sciatica), which often begins as pain in the hip or buttocks
  • Feeling of heaviness or weakness in the legs
  • Clumsiness, tripping, falls

Pain from spinal stenosis typically worsens when you stand or walk. Sitting or leaning forward may relieve the pain by taking pressure off the involved nerves. Conservative measures resolve spinal stenosis symptoms in many but not all patients. Back surgery may be considered if you have persistent pain, leg weakness or bowel or bladder problems related to the spinal stenosis.

Posted in Arthritis on August 26, 2013


Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


What is the best physiotherapy for moderate to marked spinal stenosis together with narrowing of foramina, marked neural foraminal narrowing, and lumbarization?I would like to avoid surgery and am 83 years old.

Posted by: optima | September 14, 2013 10:32 AM

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