Lumbar Stenosis

What is lumbar stenosis?

Lumbar stenosis is a narrowing in the lower part of the spinal canal. The spinal canal is the hollow space in the back bones (vertebra) that the spinal cord sits inside. Lumbar means the lower part of the back. This is a common area for this problem to occur, though the narrowing can occur in the neck or upper back area as well. Lumbar stenosis is one of the most common conditions that occur in the spine.

How does lumbar stenosis occur?

The most common cause of lumbar stenosis is degenerative arthritis. Degenerative arthritis of the vertebrae causes the joints and ligaments of the spine to get bigger, making the area for the spinal cord smaller. This increase in size puts more pressure on the nerves that come off the spinal cord.

A mass or tumor can also cause the narrowing of the space in the spinal canal. A baby can also be born with lumbar stenosis.

What are the symptoms?

Common symptoms include:

• Back pain
• Pain in one or both legs
• Numbness or tingling in the legs or feet
• Weakness in the legs
• Pain with standing or walking.

Severe symptoms are:

• Problems with walking or balance.
• Problems with bladder control.

How is it diagnosed?

The diagnosis is made by either your healthcare provider or a specialist in either orthopedics or neurosurgery. A careful history and detailed physical exam are important to making the diagnosis. X-rays of the lumbar spine may show degenerative changes in this area. Sometimes an MRI or CT scan are needed to confirm the diagnosis.

What is the treatment?

Depending on the severity of the lumbar stenosis, there are different treatment options. Physical therapy is one of the first options for treatment. This can help strengthen the muscles of the lower back. Medicine may be used to help decrease the pain and inflammation. The next step is often having a steroid injection into your back to decrease the pain and inflammation.

Most people do not need surgery. However, if physical therapy, medicine, and steroid injections are not helpful, then surgery may be an option. The most common surgery is called a lumbar laminectomy. The surgery removes anything that is causing the spine to narrow such as enlarged ligaments and joint tissue that is pressing on the nerves.

How long will the symptoms of lumbar stenosis last?

The symptoms may last for weeks to months to years. If you did not have surgery you can return to your job or activities once you are pain free, have full range of motion of your back, and your strength is fully recovered. If you have surgery, your surgeon and physical therapist will guide your recovery. Recovery from surgery usually takes several months at least. As far as strenuous activities, like exercise, you need to receive permission from your healthcare provider or physical therapist.

How can I prevent developing lumbar stenosis?

To decrease your risk of having lumbar stenosis that is caused by degenerative arthritis, you can :

• Keep your weight under control, since extra body fat places an extra load on the joints in your back.
• Exercise the muscles in your lower back, this will keep the muscles in your back strong which takes some of the pressure off the joints in your back.