What is Lumbar Spinal Stenosis?
Lumbar spinal stenosis is defined as the narrowing of the spinal canal in the lower back. This narrowing occurs when the growth of bone and/or tissue reduces the size of the channels or openings where the nerves are. This progressive narrowing can squeeze or irritate the nerves that branch out of the spinal cord. This often leads to back pain, and/or numbness, weakness or tingling in the legs, feet or buttocks. If severe, it may lead to bowel or bladder dysfunction.
Symptoms of lumbar spinal stenosis
Lumbar spinal stenosis may or may not produce symptoms, depending on how severe the stenosis is. The more the spinal canal narrows, the more likely it is to result in nerve compression. Increased pressure or inflammation of the nerves results in painful, sometimes even unbearable, symptoms. Symptoms can include:
- Numbness, weakness, cramping, tingling or pain in the legs, feet, or buttocks
- Stiffness in the legs and thighs
- Low back pain
- In severe cases, inability to control bladder or bowels
- Leg pain with walking
Causes of lumbar spinal stenosis
The most common cause of lumbar spinal stenosis is age-related changes of the spine, often referred to as degenerative arthritis. These changes include; thickening of the soft tissues, a gradual deterioration of the spinal discs and joints, loss of cartilage between the bones of the joints, formation of bony spurs, and loss of the height of the discs between the vertebrae (degenerative disc disease). Any of these processes can narrow the normal space available for the nerves and directly press on the nerve tissue to cause lumbar spinal stenosis.
Other conditions that may cause lumbar spinal stenosis include:
- An abnormally narrow spinal canal (which can be an inherited condition)
- Spinal fractures
- When the vertebrae slides forwards and backwards over the bone below, resulting in squeezing of the spinal cord or nerve roots.
How is lumbar spinal stenosis diagnosed?
Spinal stenosis can usually be diagnosed based on:
- History of symptoms
- Physical examination
- Imaging studies
Diagnostic studies include:
- CT Scan of the spine
- MRI of the spine
- Electromyelogram (EMG)
- Nerve conduction tests
Treatment options available
- Education about your condition and how to relieve symptoms
- Medications to relieve pain and inflammation such as Tylenol or anti-inflammatory drugs
- Exercise (especially riding a stationary bicycle)
- Weight loss
- Physical therapy
Treatment if the condition gets worse:
- Medications specifically directed at nerve pain
- Cortisone injections
- Narcotic medications for pain
- X stop spinal decompression device
- Decompressive laminectomy with or without spinal fusion
What can be done to control the severity of the lumbar spinal stenosis?
Unfortunately, the degenerative changes responsible for lumbar spinal stenosis can occur as part of the normal aging process. It may be impossible to ultimately prevent lumbar spinal stenosis, but you may be able to control the severity of the symptoms or delay surgical intervention by observing the following:
- Regular exercise and flexibility stretches
- Maintaining a healthy body weight
- Maintenance of good posture
- Stop smoking
- Risk reduction for falls
- Taking medications only as directed by your physician
If you have further questions regarding lumbar spinal stenosis or would like to have your particular situation evaluated, please call our office at (208)522-6930.