Lumbar spinal stenosis is when the space around the spinal cord in the lower back is narrowed. This means that some of the nerves coming from the spine are squished. The pain associated with this condition can vary greatly, but it often causes a sense of heaviness or weakness in your legs, bowel, and bladder function problems, and numbness in some parts of your body. Lots of people with lumbar spinal stenosis develop a limp.
People with lumbar spinal stenosis usually have to try a few different things to feel better. Sometimes the things that work are medicines, or they might go to physical therapy. Also, sometimes surgery is necessary.
Lumbar spinal stenosis is one of those conditions where it’s best not to wait too long before you do something about it. The longer you ignore the pain and problems you’re having, the worse they can get.
Symptoms of lumbar spinal stenosis
Lumbar spinal stenosis is a common disease. About 10% of people have it. The symptoms may be the following:
- Tightness in the lower back and difficulty in raising legs as high as you want.
- Numb or tingly in parts of the body, including feet, hands, arms, and legs.
- Troubles with walking and standing up.
- Problems with bowel or bladder control.
- Leg pain or pain in the buttock or leg muscles.
The person might have all of these symptoms at once, or only one or two.
Usually, people with lumbar spinal stenosis lose the ability to freely walk as they used to before they’ve got ill.
The cause of lumbar spinal stenosis
Lumbar spinal stenosis is a problem that happens because something has damaged the nerves around the spinal cord. This damage can be from an accident, or it could happen when you get hurt in some other way, like slipping on ice.
Sometimes people with lumbar spinal stenosis have had back surgery. They may have had surgery to repair a herniated disc or surgery to remove bone fracture from the back (decompression).
If you have been hurt – and even if you didn’t know you were injured at first – you should always tell your doctor about that.
Diagnosing lumbar spinal stenosis
Lumbar spinal stenosis can be diagnosed in different ways:
- X-ray. This can help see if the spine is damaged and if the soft parts around the spine are swollen.
- MRI scan. This is a special kind of X-ray. It can show whether there are any problems with the muscles or soft tissues around your spine. But it can take a long time (sometimes as long as two months) for an MRI to come back from the lab.
- Electromyography (EMG). In this procedure, the doctor inserts several needles into your muscles and scans them. The machine sends a signal to your body through wires from these electrodes; this helps to see if your muscles are damaged or weak.
- Ultrasound scan. This procedure lets the doctor see if there are any problems with the soft tissues around your spine.
- Nerve conduction study. The doctor puts some pieces of tape with electrodes over the skin at certain places where the nerves end. The machine measures the time it takes for the signal to get from one place back to where you have put the electrodes on your body. This can help diagnose some nerve problems.
How is lumbar spinal stenosis treated?
There exist two types of treatment of lumbar spinal stenosis: a non-surgical and a surgical one.
It often starts with medicines (oral drugs). In some cases, people need to take these medicines for days or weeks, sometimes for a couple of months or even a year.
Though, people do better if they also go to physical therapy. This can be true because the pain can be reduced a little with exercise, and some of the nerve issues (called neuropathy) that happen with lumbar spinal stenosis are also solved by exercise.
Doing physical therapy can also help you lose weight if you have some extra kilos. That’s especially helpful if you have lumbar spinal stenosis.
Sometimes, if a person has lumbar spinal stenosis, the doctor will suggest that surgery is necessary.
Types of surgeries:
There are a few different ways to fix lumbar spinal stenosis. They are:
- Microdiscectomy for spinal stenosis – during this procedure, a small portion of the bone is removed from the spine.
- Laminectomy for spinal stenosis – in this operation, part of the bone and tissue are taken off.
- Total disc replacement – in this type of surgery, your worn-out discs are removed and replaced with implants that will serve to give support to your spine, all while decompressing it.
- Fusion – with this operation, the upper and lower vertebrae are locked together.
- Lumbar spinal fusion – this is a surgical procedure in which a bone graft, metal ring, and screws are used to fuse together the spinal bones.
- Segmental spinal osteotomy – a straight cut is made in the spine bone where it meets the vertebrae on either side. Each side is separately rotated and fixed in place with plates and screws.
- Posterior lumbar interbody fusion (PLIF) – a bone graft and large vertical rods are used to stabilize the spine.
- Anterior lumbar interbody fusion (ALIF) – the surgeon makes an incision at or near the front of your abdomen to access your back. Then, they insert plates and screws in the vertebrae to stabilize them.
The final thing you should remember about lumbar spinal stenosis is that it is complicated to cure and very painful. If you have been diagnosed with this condition, you should discuss treatment options with your doctor. It would be best to remember that many of the treatments proposed by conventional medicine are controversial and may not even work at all. That’s why it is always better to hear a second opinion. It is essential to keep an open mind when it comes to your recovery, and if something isn’t working for you, then change it until you find something that suits you the best.