Central Canal Stenosis Symptoms and Causes

Depiction of disc herniation causing central canal stenosis
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Central canal stenosis occurs when the passageway that houses the the highly sensitive spinal cord narrows. This passageway is known as the spinal canal, and is discussed below. The narrowing may be due to a number of things from arthritis to genetics. Causes of central canal stenosis are also discussed below.

Most of the time, central canal stenosis is an age-related condition. It is a progressive condition, which means it keeps getting worse as time moves on.

The Spinal Canal — Where it all Happens

Simply stated, the spinal canal is a hole down the center of your vertebral column. Your spinal cord is located inside this hole. The spinal cord is a very key part of the central nervous system, which is comprised only of the "cord", as it is often called for short, and the brain.

"The spine is the structural element and the spinal cord is the electrical and conductive portion of the system," says Dr. John Toerge, D.O., and rehabilitation specialist at Medstar National Rehabilitation Hospital in Bethesda, Maryland.

In other words, Toerge continues, "the canal is made of bone and supports the body, and it supports the motion of the spine. The spinal cord, on the other hand, 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 your spinal nerve roots.

Toerge further clarifies the functions of each structure by saying that the two generally work independently of one another, except when the canal becomes narrowed, i.e., in cases of central canal stenosis. 

The narrowing may impinge on the nervous elements of the cord, and it's at that point when the diagnosis of central canal stenosis is made, he 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.

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 cramping that may be associated with prolonged walking or standing.

As an aside, you also have a peripheral nervous system which is comprised of the nerves that branch off from the cord. These nerves exit the spine from an area on the side of the spinal column known as the intervertebral foramen, and subsequently proceed to all areas of your body. Essentially, the job of the peripheral nerves is to detect and relay sensations — temperature, pain, joint and body position and more — as well as to communicate movement impulses from your central nervous to your muscles. As you can see, the peripheral and central nervous systems relate; just the same, they are considered separate entities.

What Causes Central Canal Narrowing and Stenosis

Arthritis of the spine is often at the root of central canal stenosis. Arthritis may develop on the spinal nerve roots in as well as in the canal, Toerge clarifies. 

When arthritis affects the spinal nerve roots, it's called neuroformaninal stenosis.

But genetics may play a role, as well.  

In other words, certain people are simply 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 are 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 there are less common, they are sometimes identified as underlying causes.

Disc problems, including herniation and loss of disc height, may also cause spinal canal narrowing.

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 in when making treatment decisions for lumbar spinal stenosis.

 

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