Signs and Symptoms of "Polyneuropathy" versus "Spinal Stenosis"

Mon, June 4. 2018 by Petra Gürtner

It is easy to confuse the signs and symptoms of polyneuropathy versus spinal stenosis. Numbness and tingling are the hallmark of both. Often there are painful paresthesias, I.e. simple touch may feel painful or the tips of the toes may feel very cold. Dizziness is common, since the sensation of the position of the joints in both legs may be affected, consequently there is a feeling of “walking on moss”.

Nerve conduction studies will be prolonged. The diagnosis of neuropathy will be entertained. If there is more than one limb involved, it will be called Polyneuropathy. Common causes are diabetes mellitus, alcoholism, chemotherapy and there are approximately 300 more known causes.

Spinal stenosis it’s a condition of narrowing of the spinal canal, which can occur in the cervical and even more common in the lumbar spine. It presents with exactly the same numbness and tingling in the limbs and dizziness. Unfortunately patients can have both conditions at the same time particularly in old age. The good news is that Spinal stenosis can be effectively treated by surgery.

HOW DOES ONE DIAGNOSE SPINAL STENOSIS?

A picture of an elderly gentleman standing next to a wheelchair being held by a younger lady and alongside are causes of polyneuropathy. — Causes of polyneuropathy

The easiest way to diagnose spinal stenosis is an imaging study, which is called an MRI of the cervical and lumbar spine. By visualizing the spinal canal the Compression of the nerves structures will be obvious.

There are some physical signs which hint at a compression of the nervous structures. Increasing backpain or leg pain which are relieved by sitting down or bending forward suggest a compression of the nerve roots in the lumbar spine.

An increase in deep tendon reflexes and spasticity are often associated with cervical spinal stenosis. Neck pain and shoulder pain along with loss of strength and clumsiness are telltale signs which warrant an MRI of the cervical spine.

SUMMARY

Whenever numbness and tingling cause severe dizziness, it is necessary to obtain an MRI of the cervical and lumbar spine to rule out spinal stenosis as a cause. This is true even if there are other causes for polyneuropathy. The age of the patient matters, such that spinal stenosis is very likely in the older patient. Both diseases can occur at the same time and will compound each other.

X-ray image of a spinal canal stenosis
X-ray of the spine
Causes of polyneuropathy

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