Lumbar Stenosis

Overview

Lumbar stenosis is a condition in which the spinal canal narrows in the lower back or lumbar region, putting pressure on the nerves that pass through it. This narrowing often causes pain, tingling, or numbness in the lower back, legs, or buttocks, and can cause discomfort during walking and other movements. Although lumbar stenosis is more common in older people due to age-related wear and tear, it can affect people of all ages and significantly affect quality of life. Dr Irfan Malik, who is leading the charge against the deadly condition, provides specialist care.

Symptoms of lumbar stenosis

Lumbar stenosis symptoms can vary depending on the degree of nerve compression. Common symptoms include:

• Back pain: pain is often felt in the lower back, but can also extend to the legs or buttocks. The pain may worsen with activities such as standing or walking and may disappear with sitting or bending forward.
• Numbness or Tingling: Many people experience a tingling sensation in the lower back, legs, or feet. This numbness can make it difficult to feel and control these areas.
• Leg Weakness: As the nerves become compressed, the muscles in the legs or feet can become weak, making it difficult to walk and maintain balance.
• Difficulty walking: People with lumbar stenosis often feel the need to stop when walking short distances. Leaning forward, such as pushing a shopping cart, may temporarily relieve discomfort.

These symptoms may worsen over time or remain relatively stable, depending on the cause and severity of the stricture.

When to See a consultant

If you have persistent back pain, tingling, numbness, or weakness in your legs, you may want to see a doctor. Get medical help if:

• Pain or discomfort interferes with daily activities or quality of life.
• Sudden, severe numbness or weakness in the legs or loss of bowel or bladder control. This may indicate a rare but serious condition called cauda equina syndrome, which requires immediate medical attention.
• Over-the-counter pain relievers are ineffective or symptoms worsen despite rest.

Early diagnosis and treatment of lumbar stenosis can help control symptoms and prevent the condition from significantly limiting your mobility.

Causes of lumbar stenosis

Many factors can lead to lumbar stenosis, including:

• Age-related changes: The most common cause of lumbar stenosis is degeneration of the spine due to aging. As we age, the bones and ligaments of the spine thicken and can form bone spurs, which can press on the nerves in the spinal canal.
• Herniated disc: The discs that cushion the vertebrae can slip out of place or rupture, putting pressure on the nerves.
• Thickened ligaments: As we age, the spinal ligaments can become stiff and thick, narrowing the space in the spinal canal.
• Spinal Injuries: Spinal injuries such as fractures or dislocations can cause structural changes that contribute to stenosis.
• Congenital Spinal Stenosis: Some people are born with a naturally narrow spinal canal, which makes them more susceptible to narrowing as they age.

Diagnosis of lumbar stenosis

To diagnose lumbar stenosis, your doctor will likely start with a physical exam and a review of your symptoms and medical history. Commonly used diagnostic tests include:

• X-rays: X-rays may show bone spurs or structural changes in the spine that may contribute to stenosis.
• MRI (Magnetic Resonance Imaging): MRI produces detailed images of the soft tissues of the spine, including nerves and intervertebral discs, thus helping to identify areas of narrowing.
• CT Myelogram: This test involves injecting dye into the spine before a CT scan. It helps detect areas where nerves may be compressed by narrowing.

Treatment Options for Lumbar Stenosis

The treatment for lumbar stenosis focuses on relieving symptoms and improving mobility. Options range from conservative measures to surgery in severe cases:

• Physical Therapy: Exercises to strengthen the back and abdominal muscles, improve flexibility, and enhance balance can help manage symptoms and support spinal health.
• Medications: Over-the-counter pain relievers like acetaminophen or ibuprofen can help reduce pain and inflammation. In some cases, doctors might prescribe medications such as muscle relaxants or nerve pain relievers.
• Epidural Steroid Injections: Steroid injections directly into the affected area can help reduce inflammation around the nerves and provide temporary pain relief. These injections are often recommended for people who aren’t ready or eligible for surgery.
• Assistive Devices: Using a cane or walker can help improve balance and relieve pressure on the lower back, especially for people with difficulty walking.
• Surgery: In severe cases where conservative treatments don’t provide relief, surgery may be necessary. The most common procedure called a laminectomy, involves removing parts of the vertebrae that are pressing on the nerves. Surgery is usually considered when symptoms severely impact the quality of life.