Lumbar Spinal Stenosis Pain
Your spinal cord is a combination of nerves passing down through a tunnel formed by your vertebrae. The tunnel is called the spinal canal. The narrowing of this spinal canal in the lower part of your back is called lumbar spinal stenosis. It can cause pressure on your spinal cord or can compress the nerves that go from your spinal cord to other parts of the body, such as muscles. These are the ways lumbar spinal stenosis pain develops.
Spinal stenosis can affect any part of your spine but is most common in the lower back, i.e., your lumbar area. Five lumbar vertebrae are connecting your upper spine with your pelvis.
If you have lumbar spinal stenosis, you may have difficulty walking distances, or you may need to lean forward to decrease pressure on your lower back. In some instances there could be pain or numbness in your legs. In some severe cases, there may be a loss of control over bowel and bladder function. There is no permanent cure for lumbar spinal stenosis, but many strategies can be used to prevent this condition from affecting your daily life.
What causes lumbar spinal stenosis?
Osteoarthritis is one of the most common causes of lumbar spinal stenosis. Spinal stenosis is associated with osteoarthritis because osteoarthritis begins to cause changes in most people’s spines as they pass 50. That’s why most individuals who develop signs and symptoms of spinal stenosis are 50 or older. Females are at a higher risk of developing spinal stenosis than men.
In addition to osteoarthritis, other conditions that can cause spinal stenosis pain are:
- Narrow spinal canal
- Spinal injury
- Spinal tumor
- Certain bone diseases
- History of any previous spinal surgery
- Rheumatoid arthritis
Symptoms of lumbar spinal stenosis
Early lumbar spinal stenosis may not always present with symptoms. In most people, symptoms develop gradually over time.
Main symptoms are:
- Back pain
- Burning pain radiating into the buttocks and down into the legs (sciatica)
- Numbness or tingling sensations in the leg
- Muscle cramping
- Weakness in legs
- Loss of sensation in the foot
- foot drop
- Loss of sexual ability
Compression in the lumbar region can also lead to more serious symptoms known as cauda equina syndrome.
Lumbar spinal stenosis pain diagnosis
Diagnosis of lumbar spinal stenosis starts with the assessment of your signs and symptoms. The doctor will take a complete history and will perform a complete physical examination. The purpose of physical examination would be to look for signs of spinal stenosis, such as loss of sensation, weakness, and abnormal reflexes.
After history and physical examination, the following test would help in making a diagnosis:
- X-rays
- CT scan
- Magnetic Resonance Imaging (MRI)
Depending upon your condition, your doctor, may also advise a bone scan, myelogram (a CT taken after injecting dye), and EMG (an electrical test to determine muscle activity).
Lumbar spinal stenosis pain treatment options
If you have lumbar spinal stenosis, you may have to visit many types of healthcare professionals such as arthritis specialists, nerve specialists, surgeons, and physical therapists. Treatment options are physical therapy, medicine, and, lastly surgery.
Physical Therapy:
A Physical therapist will recommend specific exercises to strengthen your back, stomach, and leg muscles. Using braces to support your back, stretching, and massage can also help you ease the symptoms and stop them from progressing to severe one.
Medicines:
Most commonly used medications for lumbar spinal stenosis are nonsteroidal anti-inflammatory medicines (NSAIDs). These medications reduce the pain and swelling. Epidural steroid injections are also used.
Acupuncture / Chiropractic Care
Acupuncture and chiropractic care can also be helpful for some individuals.
Surgery:
The last resort needed in cases not managed by other treatment options and the development of severe symptoms such as cauda equina syndrome. Surgery includes removing bone spurs and increasing the space between vertebrae. Some of the vertebrae may also be fused together to stabilize the spine.
MILD procedure
The MILD procedure, or minimally invasive lumbar decompression, is an advanced technique adopted by pain specialists. It is an effective and safe method for treating lumbar spinal stenosis. We are able to relieve the pressure in your spine with a minimally invasive technique without the need for surgery.
Vertiflex Procedure
In this procedure, a small implant is placed inside the spine to prevent the reduction of the space when standing or moving. This lifts the pressure off the nerves, decreasing leg and back pain symptoms that are often associated with lumbar spinal stenosis.
Conclusion:
Lumbar spinal stenosis is the narrowing of the spinal canal compressing the nerves. It results in the development of various signs and symptoms, including pain and weakness in the legs, numbness, tingling sensations, etc. Medications and physical therapy can reduce these symptoms. Keep observing your signs and symptoms closely.
Consult your doctor immediately if you notice severe symptoms such as loss of bowel and bladder control, inability to get out of a chair, etc.
References
- Lee, S. Y., Kim, T. H., Oh, J. K., Lee, S. J., & Park, M. S. (2015). Lumbar Stenosis: A Recent Update by Review of Literature. Asian spine journal, 9(5), 818–828. https://doi.org/10.4184/asj.2015.9.5.818
- Genevay, S., & Atlas, S. J. (2010). Lumbar spinal stenosis. Best practice & research. Clinical rheumatology, 24(2), 253–265. https://doi.org/10.1016/j.berh.2009.11.001
- Ciricillo, S. F., & Weinstein, P. R. (1993). Lumbar spinal stenosis. The Western journal of medicine, 158(2), 171–177.
- Lee, B. H., Moon, S. H., Suk, K. S., Kim, H. S., Yang, J. H., & Lee, H. M. (2020). Lumbar Spinal Stenosis: Pathophysiology and Treatment Principle: A Narrative Review. Asian spine journal, 14(5), 682–693. https://doi.org/10.31616/asj.2020.0472
- Lurie, J., & Tomkins-Lane, C. (2016). Management of lumbar spinal stenosis. BMJ (Clinical research ed.), 352, h6234. https://doi.org/10.1136/bmj.h6234
- Chen, H., & Kelling, J. (2013). Mild procedure for lumbar decompression: a review. Pain practice : the official journal of World Institute of Pain, 13(2), 146–153. https://doi.org/10.1111/j.1533-2500.2012.00574.x
- Racz, G. B., Heavner, J. E., Bosscher, H., & Helm, S., 2nd (2013). The MILD procedure. Pain practice : the official journal of World Institute of Pain, 13(7), 594–596. https://doi.org/10.1111/papr.12051
- Hartman, J., Granville, M., & Jacobson, R. E. (2019). The Use of Vertiflex® Interspinous Spacer Device in Patients With Lumbar Spinal Stenosis and Concurrent Medical Comorbidities. Cureus, 11(8), e5374. https://doi.org/10.7759/cureus.5374
- Cosgrove, J. L., Bertolet, M., Chase, S. L., & Cosgrove, G. K. (2011). Epidural steroid injections in the treatment of lumbar spinal stenosis efficacy and predictability of successful response. American journal of physical medicine & rehabilitation, 90(12), 1050–1055. https://doi.org/10.1097/PHM.0b013e31822dea76
- Hall, S., Bartleson, J. D., Onofrio, B. M., Baker, H. L., Jr, Okazaki, H., & O’Duffy, J. D. (1985). Lumbar spinal stenosis. Clinical features, diagnostic procedures, and results of surgical treatment in 68 patients. Annals of internal medicine, 103(2), 271–275. https://doi.org/10.7326/0003-4819-103-2-271
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