Lumbar Spinal Stenosis: What You Need To Know
What is Lumbar Spinal Stenosis?
Lumbar spinal stenosis or lumbar canal stenosis is the narrowing of the spinal canal of the lower back. The spinal canal is the passageway for the spinal cord. As a result, when the spinal canal gets narrow, it chokes the spinal cord or the nerves leaving it and traveling through the lower back. Lumbar spinal stenosis leads to pain, numbness, and tingling sensations in the legs. The symptoms appear due to inflammation, compression, or both. The condition may affect at a young age, though, but it is more common among people over the age of sixty.
What are the causes of Lumbar Spinal Stenosis?
The most common cause of lumbar spinal stenosis is osteoarthritis or wear and tear. As people get old, their spinal bones go through degenerative changes, causing problems that lead to stenosis. These problems include:
- Bone spurs: Wear and tear damage in the spinal bones (vertebrae) may prompt the development of bone spurs into the spinal canal. These outgrowths compress the spinal cord and cause inflammation.
- Disk herniation: The small cushions between the vertebral bones that act as shock absorbers become less spongy as people age. These disks may bulge into the spinal canal, or their soft inner material may escape through the cracks in these disks. Altogether, these problems may compress the spinal cord or the nerves.
- Thickened ligamentum flavam: The ligaments that hold the bones together may thicken and compress the spinal cord or nerves.
- Tumors: These are not common, though, but sometimes they cause spinal cord or nerves compression.
- Bone diseases and spinal injuries: Bone diseases such as osteoarthritis, Paget’s bone disease, rheumatoid arthritis may also lead to bone spur formation. Accidents or other traumas may cause vertebral dislocations or fractures, which may damage the contents of the spinal canal.
What are the signs and symptoms of Lumbar Spinal Stenosis?
The lumbar part of the spinal cord supplies nerves to the legs mostly. Hence, most of the symptoms of lumbar spinal stenosis are observed in the legs. These include:
- Pain in the lower back
- Pain and weakness in the legs, foot, or buttocks on standing and walking commonly known as neurogenic claudication
- Numbness or tingling in the legs or foot
- Cramping in one or both legs while standing for a longer duration, or walking
- The pain usually improves by bending forward, sitting, or lying down.
How to diagnose of Lumbar Spinal Stenosis?
The diagnosis of lumbar stenosis is based on:
- Sings and symptoms and medical history
- Physical examination to check for numbness, weakness, and abnormal reflexes.
- X-rays to check for bone spurs, alignment of the vertebrae, and osteoarthritic changes.
- MRI to check for damage to the disks and ligaments and the presence of tumors. It can also show if there is nerve compression.
- CT scan if you can’t have an MRI. It can detect changes to the tissues in and around the spinal canal and give a detailed look.
What is the prognosis of Lumbar Spinal Stenosis?
The disease has a good prognosis for most cases. Many people obtain good relief with medications and physical therapy. Although there is no cure, these strategies help people live an active life by keeping the pain at bay. When stenosis becomes severe, surgery may prove effective.
What are the treatments of Lumbar Spinal Stenosis?
The treatment depends upon the location and severity of lumbar spinal stenosis. Options include:
These are usually to relieve pain. Examples are as follows:
- Non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen
- Anti-depressants such as amitriptyline (Tricyclic anti-depressants)
- Anti-seizures like gabapentin and pregabalin (gabapentinoids)
- Opioids like oxycodone and hydrocodone (codeine-related drugs) only for short-term pain relief.
To reduce pain, people usually stop exercising. It leads to muscle weakness and more pain. As a result, physical therapy becomes very important. It helps to
- strengthen back and leg muscles
- Improve stability and endurance.
- Maintain flexibility
Braces to support the back, stretching, acupuncture, and massage may also prove effective.
Epidural Steroid Injection:
If the symptoms become severe and are not responding to other treatments, a doctor may recommend an epudural steroid injection. The injection is given where there is nerve irritation and inflammation. This is an image-guided interventional procedure done at operation theter. It is a very useful and best non-operative for lumbar spinal stenosis.
If other treatments don’t seem to work, then doctors consider surgery. Its purpose is to increase the spinal canal space to relieve pressure on the spinal cord or nerves. There are many surgeries to do so. One such example is laminectomy, in which the back part of a vertebra is removed.