Article by David Betz
Spinal stenosis is caused by narrowing in the openings of the vertebrae that nerves pass through. When the narrowed area is in the lower back, it is called lumbar stenosis. The symptoms of lumbar stenosis are related to the compression of nerves that go to the hips, legs and feet.
SymptomsThe most common symptom of lumbar stenosis is pain in the legs. Sometimes people will have what’s called “neurogenic claudication” pain, which is heaviness, aching or cramping in your legs when you walk. Claudication pain gets worse if you walk and is relieved by sitting or lying down. It can be caused by impaired circulation to the legs (vascular claudication) or by lumbar stenosis. The claudication pain of lumbar stenosis is usually also relieved by bending over or stooping down.
People with lumbar stenosis can also have “radicular pain,” or pain that radiates down one or both legs, also called sciatica. Other sensory abnormalities caused by lumbar stenosis are tingling, heaviness or numbness in your toes, feet and legs. Motor abnormalities include weakness in one or both legs and difficulty walking.
Rarely, severe lumbar stenosis can cause “caudae equinae syndrome.” The spinal cord itself ends in the lower back and splits into several nerves. Those nerves continue down the spinal canal and exit in pairs between the vertebrae. Lumbar stenosis that compresses the caudae equinae can cause “saddle anesthesia,” or loss of feeling where you would sit on a saddle, bladder or fecal incontinence and sexual dysfunction. It is considered a medical emergency because only a very large disc herniation or other serious problem can cause caudae equinae syndrome.
TreatmentTreatment modalities for lumbar stenosis can be divided into three categories: conservative, alternative and surgical.
Conservative treatment includes anti-inflammatory medications, muscle relaxers and pain medications. Physical therapy is often helpful in improving pain and mobility. If the pain continues, you could receive cortisone or anesthetic injections. Anesthetic injections, or nerve blocks, usually give you some relief from the pain. Cortisone injections seem to be less effective.
Chiropractic, massage and acupuncture are alternative treatments. They provide excellent pain relief for some people.
Surgery is usually a laminectomy, or removal of some of the bone around the spinal canal, to make a larger opening for the nerves. Sometimes a spinal fusion is done, too, to stabilize the vertebrae and keep them from slipping and compressing the nerves.
Many people, especially those who are older or who have other health risks, benefit from minimally invasive surgery for lumbar stenosis. The surgeon views the lumbar spine with a microscopic endoscope and uses microsurgical techniques to make specific repairs. Endoscopic surgery is less invasive and better tolerated than traditional surgery.
About the Author
David Betz is a consultant doing work for Laser Spine Surgery http://www.laserspineinstitute.com andHouston Web Site Design http://www.novatexsolutions.com
