Lumbar Spinal Stenosis

Early lumbar spinal stenosis may have no symptoms. In most people, symptoms develop gradually over time. Common symptoms may include:

• Pain in the back
• Burning pain going into the buttocks and down into the legs (sciatica)
• Numbness, cramping, or weakness in the legs
• Loss of sensation in the feet
• A weakness in a foot that causes the foot to slap down when walking ("foot drop")
• Loss of sexual ability

Pressure on nerves in the lumbar region can also cause more serious symptoms known as cauda equine syndrome. If you have any of these symptoms, get medical attention right away:

• Loss of bowel or bladder control
• Severe or increasing numbness between your legs, inner thighs, and back of the legs
• Severe pain and weakness that spreads into one or both legs, making it hard to walk or get out of a chair

To diagnose lumbar spinal stenosis, your doctor will ask you questions about your symptoms and do a complete physical examination. During the physical examination he or she will look for signs of spinal stenosis, such as loss of sensation, weakness and abnormal reflexes. Additional tests can help make a diagnosis:

• Lumbar Spine X-rays: These may show narrowing of the spinal canal and/or bone growths called spurs that push on spinal nerves.
• Imaging Tests: A CT scan or MRI scan can give a more detailed look at the spinal canal and nerve structures.
• Other Studies: Your doctor might order a bone scan, myelogram (a CT taken after injecting dye) and/or EMG (an electrical test of muscle activity).

If you have lumbar spinal stenosis, our first course of action is to help relieve the pain you’re experiencing. Except in emergency situations, such as cauda equina syndrome, surgery is usually the last resort. We’ll work together with many different medical practitioners to help relieve your pain and get you back to a fulfilling life. These experts may include pain management, arthritis and nerve specialists, surgeons and physical therapists. Treatments include:

• Medications: May include nonsteroidal anti-inflammatory drugs that relieve pain and swelling, and steroid injections that reduce swelling.
• Physical Therapy: May include exercises to strengthen your back, abdominal and leg muscles. Learning how to do activities safely, using braces to support your back, stretching and massage may also be helpful.
• Acupuncture: Can be useful in relieving pain.
• Chiropractic Care: Can help relieve pressure and pain in your back and spine.
• Home Remedies: Simple home remedies like an ice bag, heating pad, massage or a long, hot shower can help. Ask your health care provider if you should try any nutritional supplements and discuss any alternative treatments or medications you’re thinking about trying.
• Surgery: Surgical treatments include removing bone spurs and widening the space between vertebrae. The lower back may also be stabilized by fusing together some of the vertebrae. Surgery is usually a last resort.

The best way to manage lumbar spinal stenosis is to learn as much as you can about your disease, work closely with your medical team, and take an active role in your treatment. Keep your lower back as healthy as possible by maintaining a healthy weight, practicing good body mechanics and getting regular exercise.