Central Canal Stenosis Symptoms and Causes

Central canal stenosis occurs when the passageway that houses the spinal cord becomes narrow. This passageway is known as the spinal canal. The narrowing can occur as the result of a number of factors, such as arthritis and genetic predisposition.

Most of the time, central canal stenosis is age-related, and it is usually progressive, worsening over time.

Doctor looking a spine figure with her patient
 Science Photo Library / Getty Images

The Spinal Canal Is Where It All Happens

The spinal canal is a long tunnel down the center of your vertebral column. Your spinal cord, often described as the cord, is located inside this tunnel. The spinal cord is a key part of the central nervous system, which is comprised of the cord and the brain.

Dr. John Toerge, D.O., and rehabilitation specialist at Medstar National Rehabilitation Hospital in Bethesda, Maryland says, "the canal is made of bone, and it supports the motion of the spine. The spinal cord provides the means of transmitting the impulses from the brain and other areas of the nervous system to the rest of the body."

Along with the cord, the spinal canal houses blood vessels, fat, and spinal nerve roots.

Spinal Foramen

Your peripheral nervous system is comprised of the nerves that branch off from the spinal cord. These nerves exit the spine from the intervertebral foramen at the sides of your spine and extend to all areas of your body.

The peripheral nerves detect and relay sensations—temperature, pain, joint and body position—and communicate movement impulses from your central nervous system to your muscles.

What Causes Central Canal Narrowing and Stenosis

A narrow spinal canal may impinge on the cord, and it's at that point when the diagnosis of central canal stenosis is made, Toerge adds. Narrowing in the spinal canal compresses the spinal cord and the spinal nerve roots, says Dr. Judith Glaser, a physiatrist and acupuncturist practicing in New Hyde Park, New York. Neuroformaninal stenosis is the narrowing of the intervertebral fortamen.

And according to Dr. Sergio Gonzalez-Arias, medical director of Baptist Health Neuroscience Center in Miami, Florida, a compressed cord may cause any number of symptoms including (but not limited to) pain, weakness, numbness, clumsiness, and possibly bowel and/or bladder problems. A classic symptom, he says, is neurogenic claudication. Neurogenic claudication refers to a cramping sensation that may be associated with prolonged walking or standing.

Causes

Arthritis of the spine often leads to central canal stenosis. Arthritis can also develop in the intervertebral foramen, as well as in the canal, Toerge clarifies. Disc problems, including herniation and loss of disc height, may also cause spinal canal narrowing.

But genetics may play a role, as well. Some people may be born with narrow spinal canals. "Some individuals have a small canal and a large spinal cord or a large canal and small spinal cord, with the latter being the better scenario," Toerge continues.

Not only that, but a wide variety of differences in the size of your spinal canal relative to the size of your spinal cord is possible. Toerge informs me that these differences greatly determine the issues people face with their central canal stenosis diagnosis. 

Glaser adds tumor to the list of causes of central canal stenosis, stating that while they are less common, they are sometimes identified as underlying causes.

A Word From Verywell

But living a sedentary life is the highest risk of all, Toerge concludes. This is because you need to use your muscles regularly in order to stay mobile and functional. If your sedentary way of life leads to a loss of physical function, "the outcome can have serious consequences."

Acupuncture may provide one way to improve your physical functioning impairments due to central canal stenosis. A 2018 study published in BMC Complementary Alternative Medicine found that acupuncture was more effective than exercise for improved physical functioning and more effective than medication for patient satisfaction.The researchers suggest that doctors and patients factor their results when making treatment decisions for lumbar spinal stenosis.

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  1. Oka H, Matsudaira K, Takano Y, et al. A comparative study of three conservative treatments in patients with lumbar spinal stenosis: lumbar spinal stenosis with acupuncture and physical therapy study (LAP study). BMC Complement Altern Med. 2018;18(1):19. doi:10.1186/s12906-018-2087-y

Additional Reading
  • Email Interview. Toerge, J. DO, MedStar National Rehabilitation Hospital, Bethesda, MD. January 2014.

  • Sources:
  • Email Interview. Glaser, J. DO, LAC, Restorative Medicine in New Hyde Park, NY January 2014.
  • Email Interview. Gonzalez-Arias, Sergio M.D., Medical Director, Baptist Health Neuroscience Center, Miami, FL. January 2014.
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