Lumbar Spinal Stenosis
Spinal Stenosis is a narrowing of one or more areas in your spine. This occurs most often in your neck or lower back. When this narrowing takes place, it can put pressure on the spinal cord or spinal nerves at the level of compression.
The most common cause of lumbar spinal stenosis is associated with age-related changes in the spine such as degenerative arthritis (osteoarthritis). Arthritis that commonly occurs as part of the aging process can lead to loss of the cartilage between the bones at the joints, the growth of bony spurs that push on the spinal cord, thickening of the ligaments that help hold the bones of your spine together, as well as loss of the normal height of the discs between the vertabrae. These changes in the spinal column reduce the normal space available for the nerves and can press directly on the nerve tissues resulting in spinal stenosis.
The symptoms of spinal stenosis may vary depending on which nerves are affected. Common symptoms of lumbar stenosis may include:
- Numbness, weakness, cramping, or pain in the legs, feet or buttocks usually worse when walking, standing straight, or leaning backward. The pain may get better when you sit down or lean forward.
- Stiffness in the thighs and/or legs.
- Low back pain.
- Loss of bladder / bowel control (in severe cases.
Spinal Stenosis of the lumbar spine can be difficult to diagnose as its signs and symptoms are similar to many other age-related conditions. Diagnosis starts with a complete medical history and a physical examination. It is important that you provide your doctor with pertinent information such as when the symptoms started and how long they have been present as well as what positions make it feel better or worse if any and if there are any other symptoms or medical conditions the doctor needs to be aware of.
Tests such as X-rays, MRIs, and CT Myelogram may be ordered to assist in the diagnosis. Although an X-ray isn't likely to confirm spinal stenosis, it can help rule out other similar conditions such as fractures and bone tumors. MRIs can detect damage to discs and ligaments as well as detect the presence of tumors. It will also show whether or not there is pressure on the spinal cord or nerves. During a CT Myelogram X-rays are taken after a contrast dye is injected into the spinal column. This will show whether there is evidence of herniated discs, bone spurs or tumors.
In most cases, the treatment for lumbar spinal stenosis begins conservatively. This may include over-the-counter pain medications or prescription medications to relieve pain and inflammation. Physical therapy may also be part of your conservative treatment and may help in controlling your pain by building up strength and endurance as well as maintaining flexibility and stability of your spine.
In addition to the above conservative treatments, steroid injections may also be included as part of your treatment to help reduce inflammation and relieve some of the pain and pressure so that you are able to complete your therapy.
However, in more severe cases where conservative treatments haven't helped or they are not an option because you're disabled by your symptoms and you can't function through your normal daily activities, then surgery may be considered if you are in otherwise good health. The goal of surgery for spinal stenosis is to relieve the pain, numbness or weakness in the thighs and legs. Back pain from spinal stenosis may not be totally relieved through surgery so further therapy may be added as part of the recovery process. Our experts at SCCNS have years of experience in treating spinal stenosis and can discuss the benefits and the risks of surgery. We believe that educating our patients and helping them understand their condition will allow them to make an informed decision as to their treatment and have a more successful procedure.