About Lumbar Stenosis
Lumbar Stenosis is a condition marked by the narrowing of the spinal canal in the lower back, the channel for the nerves. This can cause compression of your lumbar spinal nerves and lead to nerve irritation. Lumbar stenosis often replicates symptoms of vascular insufficiency or sciatica. Symptoms of lumbar stenosis include pain and/or tingling that radiates down both legs while standing or walking. The pain is often relieved while sitting or lying down, or when leaning on objects such as a shopping cart. These patterns of symptoms are called neurogenic claudication. Although conservative management, medications, and physical therapy have a role, significant lumbar stenosis is usually best treated with surgery.
Lumbar stenosis is common in people ages 50 and over. It is estimated that over 400,000 Americans suffer from pain caused by lumbar stenosis.
Common Symptoms of Lumbar Stenosis
The most common symptom of lumbar stenosis is increasing pain in the back and legs. Pain is usually experienced most when walking. Severity of symptoms depends on each case, with symptoms typically fluctuating in severity and frequency.
Lumbar stenosis symptoms may include:
- Back pain
- Leg pain
- Leg pain when walking
- Tingling/weakness/numbness in the lower back into the buttocks and legs.
Diagnosis of Lumbar Stenosis
Lumbar stenosis is diagnosed through a thorough clinical history and exam in conjunction with results from an MRI or CT scan. There are three main types of stenosis, making it essential that the right type is diagnosed to ensure proper treatment. The three types of stenosis are:
- Lateral stenosis – most common type – caused by a compressed nerve root that lies along the periphery of the spinal canal
- Central stenosis – occurs when the central canal in the lower back is narrowed
- Foraminal stenosis – caused by a nerve root compressed as it exists the spine
Treatment Options for Lumbar Stenosis
Non surgical treatment options for lumbar stenosis include:
- Activity modification
- Anti-inflammatory drugs
- Epidural injections
If a patient is unable to participate in daily activities and symptoms are not reduced, surgery should be considered. Some surgical options include:
- Lumbar laminectomy – removal of part of the lamina and facet joint to relieve pressure and provide access to explore for any displaced disc material.
- Foraminotomy – removal of part of the facet joint to decompress the nerve as it exits the spine
- Microdecompression – minimally invasive procedure used to decompress affected nerves