01/22/2026
Movement is imperative to avoiding this situation. Once you have it, movement is imperative to restore proper function as much as possible. ,,,,,
š Spinal Stenosis: Detailed Pathomechanics Explained
Spinal stenosis refers to a pathological narrowing of the spinal canal, lateral recess, or intervertebral foramina, leading to compression of the spinal cord or nerve roots. This narrowing most commonly develops due to age-related degenerative changes, particularly in the cervical and lumbar spine, where mobility and load-bearing demands are greatest.
From a pathomechanical perspective, the process usually begins with intervertebral disc degeneration. As discs lose water content and height, they bulge posteriorly into the spinal canal. Reduced disc height also alters segmental biomechanics, increasing load transfer to the facet joints and ligamentous structures. This shift accelerates degenerative cascades within the motion segment.
The facet joints respond to increased loading by undergoing hypertrophy and osteophyte formation. These bony overgrowths encroach into the spinal canal and lateral recess, further reducing space available for neural tissues. Facet joint degeneration also promotes abnormal spinal motion, contributing to micro-instability and progressive narrowing during extension-based postures.
A critical contributor to stenosis is ligamentum flavum hypertrophy and buckling. Normally elastic, this ligament thickens and loses elasticity with aging and chronic stress. During spinal extension, the thickened ligament buckles inward, significantly reducing canal diameter. This explains why symptoms of spinal stenosis typically worsen in standing and walking and improve with spinal flexion.
As canal dimensions decrease, neural compression and vascular compromise occur simultaneously. Compression of nerve roots disrupts axonal conduction, while reduced blood flow leads to ischemia of neural tissues. In lumbar spinal stenosis, this mechanism produces neurogenic claudication, characterized by leg pain, heaviness, numbness, or weakness that increases with walking and eases with sitting or forward bending.
Posturally and biomechanically, patients often adopt a flexion-biased posture to increase spinal canal area and reduce neural compression. While this strategy provides short-term symptom relief, it alters normal spinal alignment and load distribution, potentially accelerating degeneration at adjacent spinal segments.
š¹ Key pathomechanical takeaway:
Spinal stenosis is not caused by a single structure but results from a multifactorial degenerative process involving discs, facet joints, ligaments, and neural elements. Symptoms arise from the combined effects of mechanical compression, altered spinal kinematics, and compromised neural circulation.
𦓠Spinal stenosis is a dynamic conditionāposture and movement play a critical role in both symptom provocation and relief.