Lumbar spinal stenosis is a condition that results from the narrowing of the nerve channels in the lower part of the back. This can cause back and leg pain that can limit your daily function and quality of life.
The most common cause of lumbar spinal stenosis is degeneration of the joints in the spine. This degeneration is a part of the normal aging process. As the joints in our spine degenerate, or become arthritic, they lose their cartilage, and bone spurs can form. Another result of the aging process is the degeneration of our spinal discs and an overgrowth of the ligaments near the spine. All of these forms of degeneration cause the nerve channels to become smaller. The result is pressure on the nerves, which may cause pain.
The symptoms of lumbar spinal stenosis include lower back pain, leg pain, leg weakness and leg numbness or tingling. In more severe cases, patients may experience a loss of bowel or bladder control and/or the inability to walk. In most instances, the symptoms of spinal stenosis are worse when walking. The symptoms often improve or resolve when the patient sits or lies down.
Additionally, a person's symptoms may improve when they lean forward as they walk, such as leaning over a grocery cart. The most common scenario is the ability to walk short distances followed by the need to stop and rest due to leg pain. After a short rest period, a short period of walking is usually able to be resumed.
Most cases of lumbar spinal stenosis gradually worsen with time. People with spinal stenosis may notice a gradual decrease in the distance they can walk and increase in pain. If untreated, these symptoms can result in progressive weakness, loss of function of the legs and loss of bowel and bladder control. If this occurs, medical attention should be sought immediately.
To determine if someone has lumbar spinal stenosis, a medical provider obtains a complete medical history and performs a physical examination. Specific tests, such as xrays, MRI's or CT scans may be helpful to provide additional information.
The treatment for lumbar spinal stenosis depends on the severity of the symptoms and the results of an evaluation. For mild or moderate spinal stenosis, medications may be recommended to help reduce inflammation of nerves. Physical therapy can improve strength and flexibility. Cortisone injections in the lumbar spine can be used to reduce pain and inflammation around nerve tissue.
Surgery may be an option for those who do not improve with non-surgical treatment. Surgery may also help if the symptoms are severe, or result in the loss of bowel or bladder control or cause severe weakness in the legs.