Lumbar Spinal Stenosis

There are two types of spinal stenosis – cervical (neck) and lumbar (lower back). Lumbar stenosis is a common cause of lower back pain. It happens with normal wear-and-tear as we age. Lumbar spinal stenosis often is seen in patients over the age of 60.

Spinal stenosis is the narrowing of the spinal canal. As the spinal canal narrows, it puts pressure on the spinal cord and spinal nerve roots. Some people do not feel anything, while others may feel pain, numbness or weakness in their legs.

Causes

Arthritis is the most common cause of lumbar spinal stenosis because arthritis causes disk degeneration over time. As the disk degenerates, it loses water content. As we age, our disks dry out and weaken, which causes the disk space around our vertebrae to collapse. As this collapse takes place, weight and extra pressure is put on our joints behind the spinal cord and the tunnel that our spinal nerves exit through becomes smaller.

Symptoms

Spinal stenosis does not necessarily mean a person will experience back pain. Some people experience a burning, numbness or tingling sensations in their buttocks or legs, weakness in their legs or less pain as they lean forward or sit.

Diagnosis

If you visit for your doctor with back pain, your doctor will start by taking your medical history and performing a thorough physical exam. Your doctor probably will request an x-ray, MRI scan or CT scan. These tests can help the doctor confirm your diagnosis or rule out certain conditions.

Treatment

Non-surgical treatment

Your doctor will try nonsurgical treatments before suggesting surgery for spinal stenosis. Nonsurgical treatment focuses on relieving pain and restoring function. While nonsurgical treatments will not undo the narrowing of the spinal canal, these treatment options can help relieve pain and discomfort and help people get back to doing the things they love.

Some common nonsurgical treatment options include:

• Physical therapy
• Anti-inflammatory medication (like ibuprofen)
• Steroid injections (like cortisone) – this can reduce the swelling around the nerves, however you don’t want more than three injections a year
• Acupuncture – this can be used in less severe cases of lumbar stenosis. While we do not perform acupuncture in our offices, you can find a certified acupuncturist in Massachusetts via the Acupuncture Society of Massachusetts.

Surgical treatment

A patient whose quality of life has deteriorated due to lumbar stenosis could be a candidate for spinal surgery. There are different surgical options for treating spinal stenosis, like a laminectomy. Some patients may be a candidate for a minimally invasive surgery to treat their lumbar stenosis. If you are a candidate for surgery, talk to your doctor about which option is best for you.