SPINAL STENOSIS

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Spinal stenosis is a common degenerative spine condition that occurs when the spinal canal narrows, placing pressure on the spinal cord or nerve roots. This narrowing often develops gradually and can lead to persistent lower back pain, leg pain, numbness, and difficulty walking. 

In Singapore, spinal stenosis is frequently seen among adults aged 50 and above, particularly those with sedentary work habits, long hours of sitting, poor posture, or age-related joint wear. While not everyone with spinal canal narrowing experiences symptoms, those who do may find daily activities such as walking, standing, or commuting increasingly challenging. 

At Singapore Paincare, our pain specialists provide minimally-invasive treatments that relieve pain safely and effectively—offering an alternative to long-term medication or surgery, often with little to no downtime. Our goal is to help you get back to your daily life with comfort and confidence. 

Lower Back Pain

What Causes Spinal Stenosis?

Spinal stenosis most commonly develops due to degenerative changes in the spine over time. Unless a person is born with a naturally narrow spinal canal (congenital stenosis), the condition is usually acquired. Common causes include: 

Degenerative osteoarthritis

Progressive wear and tear can cause bone spurs to grow into the spinal canal, reducing space for nerves.

Thickening of spinal ligaments

Ligaments in the spine may stiffen and enlarge with age, further crowding the canal.

Bulging or protruding intervertebral discs

Disc bulges can encroach into the spinal canal or nerve openings, contributing to nerve compression.

Risk factors: 

  • Being born with a narrow spinal canal
  • Female gender
  • Age 50 years and above
  • Overweight or obesity (BMI > 30)
  • Previous spinal injury or surgery
  • Poor posture or prolonged sitting habits

What are the Types of Spinal Stenosis?

The symptoms of spinal stenosis are closely linked to the location of the narrowing. The two main types include: 

Cervical Stenosis (Upper Spine)

Cervical spinal stenosis occurs in the neck region. Patients may experience midline neck pain, stiffness, or symptoms affecting the arms and hands, such as numbness or weakness. When the spinal cord itself is compressed, this may lead to myelopathy, a condition that can affect coordination, balance, and movement throughout the body below the neck.

Lumbar Stenosis (Lower Spine)

Lumbar spinal stenosis is the most common form and affects the lower back. It primarily impacts the legs and thighs, often causing pain, heaviness, or weakness when standing or walking. In more severe cases, compression of the lower spinal nerves can result in Cauda Equina Syndrome, which requires urgent medical attention.

What Are the Symptoms of Spinal Stenosis?

Symptoms often develop gradually and may worsen over time, particularly with prolonged standing or walking. Common symptoms include:

  • Radiating pain: Pain that travels down the arms or legs due to nerve compression, often described as sharp, burning, or aching.
  • Sensory changes: Numbness, tingling, or “pins and needles” sensations in the arms, legs, or feet.
  • Muscle cramping or weakness: Reduced strength or cramping in the legs and thighs, which may limit walking endurance.
  • Balance and walking difficulties: Decreased sensation in the feet can make it harder to feel the ground, affecting stability and confidence while walking.

Severe Symptoms That Require Urgent Medical Attention

Spinal stenosis exists on a spectrum. When nerve or spinal cord compression becomes severe, it can lead to serious and potentially irreversible neurological damage. Seek immediate medical care if any of the following occur:

  • Bowel or bladder dysfunction: Sudden loss of control or abnormal changes in bladder or bowel function.
  • Saddle anaesthesia: Numbness in the groin, inner thighs, or loss of sexual function.
  • Progressive neurological deficits: Partial or complete weakness or paralysis of the legs.
  • Sudden mobility changes: A rapid deterioration in walking ability, coordination, or the onset of upper limb spasms.

Prompt evaluation and treatment in these situations are critical to prevent permanent nerve injury and preserve long-term function.

What Are the Treatment Options for Spinal Stenosis in Singapore?

Conservative Treatments

If your spinal stenosis is mild or moderate, you may benefit from conservative treatments, including:

  • Medications: Anti-inflammatory drugs and nerve-stabilising medications help reduce pain and nerve irritation.
  • Physical therapy and strengthening programmes:Targeted exercises improve spinal stability, posture, and walking tolerance. Modalities such as soft laser therapy may be used to reduce inflammation.

Minimally Invasive Procedures

For persistent or more severe spinal stenosis, minimally invasive treatments can target the exact source of pain without the need for open surgery. At Singapore Paincare, we offer precise procedures designed to relieve pain at its origin.

Laser Ballooning Injection (Neuroplasty)

A minimally invasive procedure where doctors use specialized techniques to create more space in your narrowed spine, relieving pressure on pinched nerves. This outpatient treatment typically takes 30-60 minutes under local anesthesia. Most patients go home the same day with reduced pain and faster recovery than traditional surgery, experiencing significant improvement in walking distance and comfort.

Surgical Treatment

Surgery may be considered  when symptoms are severe or progressive and do not respond to non-surgical care. 

  • Open Surgical Decompression: A conventional spine operation where bone or thickened tissue is removed to relieve pressure on the spinal cord or nerves. It is typically reserved for severe or emergency cases, as it involves a larger incision, longer recovery, and higher risks. 

Since surgery carries associated risks, complications, and significant downtime, it may not be suitable for everyone and is reserved for cases where less invasive options have been exhausted. 

How Singapore Paincare Treats Spinal Stenosis? 

At Singapore Paincare, our specialists use the proprietary Painostic® method, developed from years of clinical experience, to accurately identify the exact source of nerve compression causing spinal stenosis—whether within the spinal canal or at the nerve exit points. This in-house approach goes beyond standard imaging to precisely map treatment pathways tailored to the type and severity of spinal stenosis affecting each patient.

We focus on the least invasive options first, including targeted injections and minimally invasive interventional procedures to reduce inflammation, relieve nerve pressure, and improve walking tolerance, often supported by medication and physical or cognitive rehabilitation. Even in complex or persistent cases, this integrated approach helps relieve pain, improve mobility and reduce the risk of recurrence.

How to Prevent Spinal Stenosis?

While age-related changes cannot be completely prevented, these practices can help reduce your risk of developing symptomatic spinal stenosis or slow its progression: 

  • Maintain a healthy weight to reduce load and stress on your spine—particularly important in preventing accelerated degeneration 
  • Exercise regularly with focus on core strengthening, flexibility, and low-impact activities like swimming or walking that don’t jar your spine 
  • Practice good posture throughout the day, especially during long hours at your desk—common in Singapore’s office culture 
  • Use proper body mechanics when lifting or carrying objects to avoid placing excessive strain on your spine 
  • Stay active and avoid prolonged sitting—take regular breaks to stand, stretch, and move 
  • Address any spinal problems or injuries promptly before they lead to chronic changes 
  • Engage in flexibility exercises and stretching to maintain spinal mobility and reduce muscle tension 

 

Frequently Asked Questions 

No. While osteoarthritis often leads to the bony overgrowth that causes stenosis, the condition can also result from thickened ligaments, disc bulges or herniations, congenital narrowing (being born with a naturally narrow spinal canal), or scar tissue from previous injuries or surgeries. Multiple factors often contribute simultaneously.

No. While both can cause nerve compression, spinal stenosis refers to narrowing of the spinal canal, whereas a slipped disc involves disc protrusion.

Most cases do not require surgery. Many patients improve with medications, physical therapy, and minimally invasive procedures.

Yes, but activities should be guided by a pain specialist. Appropriate exercise often improves symptoms and walking tolerance.

It may progress if untreated, but early diagnosis and proper management can significantly slow progression and improve quality of life.

A Message About Spinal Stenosis from Our Pain Specialist 

Spinal stenosis often starts as mild leg discomfort or back aching, but if ignored it can progressively affect your mobility, independence, and quality of life. Age-related degenerative changes, disc bulges, and thickened ligaments are common triggers. If left untreated, the narrowing worsens, nerve compression increases, and you may develop difficulty walking, balance problems, or in severe cases, permanent nerve damage. 

Many people assume spinal stenosis pain is just normal aging or arthritis they must live with. In reality, treatable nerve compression, weak supporting muscles, or specific structural issues are often the real causes of your symptoms. That's why the first step is always to find out exactly where your pain comes from. 

  

At Singapore Paincare, our Painostic® method goes beyond treating symptoms. We identify the real source of discomfort and build an individualised, minimally invasive plan — so you can move comfortably and confidently again.