What Is Lumbar Spinal Stenosis?
Lumbar spinal stenosis implies a narrowing either of the central portion of the spinal canal or the portions on the side where the nerves exit. Spinal stenosis, in general, occurs in the cervical, and lumbar areas. The mid-back or the thoracic region is rare to have spinal stenosis. In the low back, there are five vertebral bodies with interposed discs. The spinal canal centrally or laterally can gradually narrow due to thickening of ligaments or worsening arthritis causing a squeeze of the nerve roots and even the spinal cord. The causes of spinal stenosis are usually age-related.
By the time we reach 50 years of age, bulging discs and arthritis, as well as degeneration of the discs, can all contribute to lumbar spinal stenosis. Symptoms of lumbar spinal stenosis include sensations of pain traveling down the distribution of the nerve, stiffness numbness, or weakness across the legs, low back, and hips. Gait and incoordination as well as basic balancing may present when trying to walk. The patient often reports improvement when leaning over a cart or table and worsening of pain with walking and standing. Neurogenic claudication may occur, meaning pain in the legs due to squeezing of the nerves with activity. Diagnoses involve a thorough history and physical as well as proper imaging including CAT scans, x-rays, MRI, electrodiagnostic studies, and
bloodwork in certain cases treatment options for lumbar spinal stenosis includes analgesics for temporary pain relief, antiepileptic medications to help deaden sensitive nerves, low-dose antidepressants which are helpful in both sleep and chronic pain, as well as opioid use for worsening chronic pain. Physical therapy including home exercises to help strengthen and improve the flexibility of the spine is important. Epidural steroid injections, as well as facet joint injections and trigger points injections into local muscles, may also be effective and augment the effects of oral medication and physical therapy. If all of these fail one can be evaluated for their candidacy for surgery.
