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 your leg muscles.

Spinal stenosis can affect any part of your spine but is most common in the lower back, i.e., your lumbar area.  Spinal stenosis pain is a common spinal condition that typically occurs in people over 50. However, the condition could also arise in younger people who have sustained spinal injuries or have a congenitally narrow spinal canal.

Many people with this condition experience some type of pain, numbness or weakness, but some people are completely asymptomatic.

The board certified and fellowship trained physicians at Carolinas Pain Center are experts in diagnosing and treating lumbar spinal stenosis with minimally invasive options.

What Is Spinal Stenosis Pain?

Spinal stenosis is a condition in which the space in your spinal column gets narrowed. Your spine protects your spinal cord and allows you to stand, bend over, and twist from side to side. When the spaces between your spine get narrowed, it can put pressure on your spinal cord and the nerves located there. This is why many people face numbness or pain with spinal stenosis.

What are some symptoms of Lumbar Spinal Stenosis or LSS?

Spinal stenosis in the back can cause:

  • Pain in the low back
  • Numbness or pins-and-needles in the legs and feet that may become more pronounced when standing or walking
  • Weakness in the legs or feet
  • Aching or burning pain that radiates down the butt and leg towards the foot that gets worse when standing or walking and feels better when leaning forward (sciatica)
  • Trouble walking or balancing

Severe cases of stenosis may also affect bowel function, bladder function, and sexual function. Contact your healthcare provider or a back pain specialist immediately if you notice a change in any of these functions.

Causes of Spinal Stenosis Pain

What causes lumbar spinal stenosis?

Spinal stenosis can be caused by many different injuries, conditions, or simply the wear and tear of aging. Essentially, the cause of spinal stenosis can be anything that changes the spine’s structure and narrows the space around your spinal cord and nerve roots. When these nerves become pinched, they result in pain (such as sciatica) mentioned above in the common symptoms section.

Some common causes of spinal stenosis are:

Lumbar spinal stenosis pain diagnosis

Diagnosis of lumbar spinal stenosis starts with the assessment of your signs and symptoms. The doctors at Carolinas Pain Center 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.  

How to Prevent Spinal Stenosis

Unfortunately, since many cases of spinal stenosis are due to natural wear and tear on the spine, there is no way to prevent spinal stenosis with 100% certainty. But there are a few things that you can do to lessen your risk of developing this condition or slow its progression.

Maintaining a Healthy Body Weight

This means following a healthy diet and ensuring to incorporate movement into your day, primarily if you work at a desk or do not naturally get a lot of activity during the day. The more weight we have, the harder our spine and legs need to work to move. This can strain your body and lead to conditions like spinal stenosis.

Practicing Good Posture 

Good posture keeps our joints and bones in the correct alignment, so our muscles can be used correctly. Maintaining good posture helps to lessen the amount of wear and tear and strain placed on joints and ligaments and prevent fatigue from the incorrect use of our muscles.

Exercising

Working your core and back muscles is one of the best ways to lessen your likelihood of developing any type of back injury or condition. These muscles stabilize our spine and make bending, twisting, and even standing much easier on the spine.

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 

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  7. 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
  8. 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
  9. 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
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