While most people aren’t severely disabled, lumbar spinal stenosis can cause pain, numbness or weakness, most often in the legs, feet, and buttocks.
Lumbar Spinal Stenosis Defined
Lumbar spinal stenosis is a medical condition that occurs when there is a narrowing of the spinal canal. When this occurs in the lower back (lumbar region), it puts pressure on the spinal cord and/or nerves. The pressure can cause pain, numbness, and weakness in the legs. At the Southwest Scoliosis and Spine Institute, our orthopedic surgeons, Richard Hostin, MD, Devesh Ramnath, MD, Ishaq Syed, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD, are all board-certified, fellowship-trained surgeons with years of experience treating patients with complex spine conditions – including lumbar spinal Stenosis.
Unfortunately, lumbar spinal stenosis or lumbar stenosis primarily affects adults (50 years old and older). Similarly, this condition results from normal age-related causes like wear and tear, arthritis, or both. Other conditions that can lead to this include:
- A fall or accident
- Lumbar disc herniation
- Degenerative scoliosis
- Spondylolisthesis (in which one vertebra slips over the one beneath it)
- Bone spurs
- Injuries to the vertebrae and/or disc(s)
- Spinal tumors
- Previous spine surgery
- Cauda equina syndrome
Questions and Answers
What are the Symptoms of Lumbar Spinal Stenosis
The most common symptoms of lumbar spinal stenosis include pain or cramping in the legs, numbness or tingling in the legs, weakness in the legs, and difficulty walking or standing for extended periods. Some people may also experience back pain, loss of bladder or bowel control, or sexual dysfunction.
How is Lumbar Spinal Stenosis Diagnosed
Lumbar spinal stenosis is typically diagnosed through a combination of physical examination, imaging tests such as MRI or CT scans, and nerve function tests. Your doctor may also ask about your medical history and any other symptoms you may be experiencing.
What are the non-surgical Treatments for Lumbar Spinal Stenosis
Non-surgical treatments for lumbar spinal stenosis may include physical therapy, exercise, pain management, and the use of assistive devices such as braces or canes. Your doctor may also recommend lifestyle changes such as losing weight, quitting smoking, or modifying your activities to reduce pressure on the spine. In some cases, steroid injections may also be used to reduce inflammation and relieve pain.
Lumbar Spinal Stenosis Symptoms
When lumbar spinal stenosis occurs, the patient may or may not have symptoms. However, when symptoms do occur, they tend to worsen over time. The most common symptoms include:
- Back pain
- Pain radiating down into the buttocks and legs (sciatica)
- Burning pain
- Numbness or tingling sensation in the legs and/or feet
- Muscle weakness in the legs and/or feet
- Narrowing of the spinal canal
Often, the pain and other symptoms of lumbar spinal stenosis decrease when sitting or leaning forward. However, they get worse when standing up straight and walking. In severe cases, this condition can lead to a loss of bladder or bowel control. While rare, it can indicate a serious condition that requires immediate medical attention.
Diagnosis and Testing
To fully understand your condition, the doctor will look carefully at your medical history before performing a thorough physical exam. During the exam, the doctor will look for any signs of limited mobility and/or pain in the lumbar spine. In addition, the doctor will also look for any problems with balancing, as well as any reductions in muscle reflexes, loss of sensation, or muscle weakness that results from the spinal cord being compressed by a disc.
If the doctor suspects you have lumbar spinal stenosis, the doctor will confirm this through X-ray imaging, CT scans, or MRI scans. Although X-rays can show issues with the bones of the spine, such as bone spurs, loss of bone height, or spondylolisthesis, CT and MRI scans are usually needed to determine problems with the soft tissue of the spinal cord and surrounding nerves.
In Addition, our practice uses an advanced digital low-dose X-ray imaging system that takes high-quality images in just seconds. Also, this system can also capture X-rays of patients while in a standing or seated position, and it’s located inside our Dallas location, meaning you and your doctor can review the X-rays quickly.
Treatment for Lumbar Spinal Stenosis
Fortunately, not all patients with this condition will require surgery, and often their condition can improve with the help of treatments. In addition to managing pain with non-steroidal anti-inflammatory drugs (NSAIDs), your doctor at Southwest Scoliosis and Spine Institute may recommend physical therapy and/or exercises designed to strengthen the muscles in the back and stabilize the spine. Furthermore, your doctor may also discuss using epidural steroid injections to decrease swelling in and around any affected nerves.
On your first visit to a back specialist, the initial diagnosis will disclose the seriousness of the problem. After the exam, your doctor will develop a specific treatment plan and in some cases, it might involve surgery. Fortunately, the vast majority of back problems do not require surgery. To clarify, our doctors consider Spinal stenosis as a slowly progressive back problem that may respond to excellent care.
With today’s advanced treatments, a variety of options exist for spinal stenosis. In most cases, simple therapies such as mild pain medicine and rest relieve the pain. If symptoms are not relieved with simple measures, physical therapy also works. Moreover, the overall goal of treatment is to make you as comfortable as soon as possible and to get you back to normal activity in a timely manner.
When taken properly, mild pain medication can reduce pain. However, the medicines will not cure or stop the progression of the problem, but they will help with pain control.
Learn more about medications used to treat back pain.
If your condition causes only mild symptoms and does not appear to get worse, your doctor may have you work with a physical therapist. Upon a patient entering a well-rounded rehab program, doctors see that it assists in calming pain. Also, it will improve the patient’s mobility and strength to help them conduct daily activities with greater ease and ability.
To reduce pain, positions, movements, and exercises are prescribed. In addition, treatments may also include lumbar traction to gently stretch the low back, easing pressure on the spinal nerves. To tone the low back and stomach muscles, exercises are used to improve fitness. As a result, the doctor may schedule therapy sessions two to three times each week for up to six weeks.
The goals of physical therapy are to help you:
- Learn to manage your condition and control symptoms
- Learn correct posture and body movements to reduce back pain
- Maximize flexibility and core strength
- Foster heart and lung fitness
Learn more about spinal rehabilitation.
Epidural Steroid Injection
An epidural steroid injection (ESI) will relieve the pain of stenosis and irritated nerve roots. Injections can help reduce swelling from inflamed tissues in the spinal canal, which may result in less irritation on the nerves. As you are aware, steroid injections contain cortisone and are given through the back into the epidural space. Sometimes, these injections are not successful in relieving symptoms, and they are only used when normal treatments have failed.
Surgery for Lumbar Spinal Stenosis
If normal treatment does not relieve a patient’s symptoms over time, the following conditions could cause surgery:
- An increase in leg weakness
- Walking with leg pain
- Trouble controlling your bowels or bladder
- Pain becomes unbearable
Because lumbar stenosis occurs more commonly in older people, the patient’s physical condition plays an important part in possible surgery. Your spine surgeon and your regular medical doctor will jointly make the surgery decision.
Therefore, the main goal to treat spinal stenosis is to remove the pressure on the nerve roots in the lumbar spinal canal. For instance, this means that the tube of the spinal canal must become larger. Additionally, any bone spurs that push into the nerve roots need to be removed. For instance, doctors refer to this type of surgical procedure as a decompression of the lumbar spine or a decompressive laminectomy of the lumbar spine.
The surgical treatment is fairly straightforward. In order to free up or “decompress” the nerves, the surgeon must remove a section of bone from the back of the spine (lamina). Then, the surgeon may also have to remove a portion of the facet joints, which provide stability to the spine. Upon removal of either or both, the spine can become loose and unstable. When this occurs, doctors will include fusion as part of the procedure. Likewise, patients with spinal instability who need surgery for spinal stenosis will likely also need lumbar fusion.
Learn more about lumbar laminectomy.
Learn more about lumbar spine fusion.
Recovery from Lumbar Spinal Stenosis Surgery
The recovery from an operation for lumbar spinal stenosis can vary depending on the type and extent of the surgical procedure, as well as the individual patient’s health and other factors. In general, most patients can expect to stay in the hospital for a few days following the surgery and then gradually resume their normal activities over a period of weeks to months.
Immediately after surgery, patients may experience some pain and discomfort, which the doctors and nurses will manage with pain medication. The doctors may also instruct the patient to wear a back brace or limit certain activities, such as bending or twisting, to help the healing process. Your doctors may also recommend Physical therapy to help regain strength and mobility.
It is important for patients to follow their surgeon’s instructions for post-operative care and rehabilitation, which may include exercises to strengthen the back and core muscles, walking or other low-impact activities, and avoiding high-impact activities such as running or jumping. It may take several months to fully recover from the surgery and return to normal activities, and some patients may need ongoing follow-up care with their surgeon or their regular doctor to monitor their progress.
Why Choose the Southwest Scoliosis and Spine Institute
There are many reasons why you should choose the Southwest Scoliosis and Spine Institute to treat your lumbar spinal scoliosis. Here are a few:
- They have a team of experienced and board-certified surgeons who specialize in treating spinal conditions, including scoliosis.
- They offer a variety of treatment options, including non-surgical and surgical treatments.
- They have a state-of-the-art facility that is equipped with the latest technology for diagnosing and treating spinal conditions.
- They have a reputation throughout the Nation for providing the very best spinal care for their patients.
- They are conveniently located in three locations in Dallas, Plano, and Frisco, Texas.
If you are considering treatment for lumbar spinal scoliosis, we encourage you to schedule a consultation with the Southwest Scoliosis and Spine Institute. They can help you to understand your condition and develop a treatment plan that is right for you.
American Association of Neurological Surgeons: Lumbar Spinal Stenosis
Lumbar Spinal Stenosis
“Lumbar Spinal stenosis is a condition where the nerves in the lower back are being compressed. Some treatments include medication, physical therapy, and epidural steroid injections. If patients do not respond to conservative treatments, surgery can help to open up the space available for the nerves.” –
Dr. Devesh Ramnath
If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment.