Lumbar stenosis is a narrowing of the spinal canal in the lower back, or lumbar area, characterized by radiating pain, numbness or weakness in the lower back, buttocks, legs and feet.
This narrowing of the spinal canal occurs when bone or tissue, or both, grow and reduce the openings in the spinal bones, and then squeeze and irritate the spinal cord nerves.
What to look for
Frequently, people afflicted with lumbar stenosis have varying degrees of low back pain.
The pain most often occurs during activities and may get worse when walking, standing or leaning backward. Some pain relief may occur when resting, sitting or bending forward.
Other symptoms, which typically occur in the lower back, buttocks, legs and feet, are:
- Cramping
- Numbness
- Stiffness
- Weakness
In severe cases, the condition can impact continence and sexual function.
Tests
Initial diagnosis of lumbar stenosis generally is based on the symptoms of lower back pain. Your doctor will examine your sensation, reflexes, gait and strength
- X-ray
- CT scans
- MRI
- Nerve Injections (usually guided by x-ray to confirm correct placement)
Treatment
The initial treatment for stenosis is to treat the symptoms rather than the condition itself. These treatments include:
- Medication such as aspirin or ibuprofen to relieve inflammation and pain
- Rest
- Physical therapy
- Posture changes, such as lying with the knees drawn up to the chest or leaning forward while walking, may relieve the pressure on the nerves
- Losing weight
- Corticosteroid injections to reduce inflammation and relieve pain
If several months of treatment have not improved the symptoms, and if the stenosis is severe, surgery to widen the spinal canal may be necessary. Because bone continues to deteriorate, additional treatment may be needed several years after even successful surgery. Operations used to treat stenosis include: - Decompressive Laminectomy — The roof of the vertebrae, called the lamina, is surgically removed. The procedure also may include removing part of the disc or fusing the vertebrae (spinal fusion).
Laminotomy — Only a small portion of the lamina is removed.
