Lumbar Stenosis
Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back, which can compress the nerves and cause various symptoms. The main symptom is neurogenic claudication – leg pain, numbness, or weakness that worsens with walking or standing and improves with sitting or bending forward. When the condition causes a person to need to sit within a block of walking, serious health issues can occur, and surgery may be recommended. These symptoms occur because the narrowed canal puts pressure on the nerves when upright, but bending forward relieves that pressure. Patients with this condition will often find they can walk further when leaning on a shopping cart, which slightly reduces the pressure on the lumbar nerves.
Other symptoms can include low back pain, numbness or tingling in the legs/feet, and difficulty controlling bladder/bowels in severe cases. The symptoms tend to come and go initially but worsen over time.
Imaging like MRI or CT scans can clearly show the narrowed spinal canal and compressed nerves, confirming the diagnosis. An MRI provides better visualization of soft tissues like discs and nerves, while a CT may be necessary to describe the bony anatomy, especially if you’ve had previous surgery.
Non-surgical treatments aim to relieve symptoms and include medications (anti-inflammatories, muscle relaxants), physical therapy, spinal injections (epidural steroids), and assistive devices like canes or walkers. However, these only provide temporary relief as they do not address the underlying structural narrowing.
If non-surgical treatments fail to provide adequate relief, surgery is an option. The most common procedure is a decompressive laminectomy, where part of the bone in the back of the spine is removed to create more space for the nerves. This can significantly improve symptoms like leg pain/weakness and allow people to walk further without claudication pain. Surgery provides a more definitive solution by directly addressing the anatomical narrowing causing nerve compression, and the subsequent ability to walk and exercise after surgery has many additional health benefits.