What Is Lumbar Spinal Stenosis?
A common cause of leg and lower back pain, lumbar spinal stenosis occurs when the spinal nerves are compressed in the lower back. In fact, “stenosis” comes from the Greek word for “choking.” Spinal stenosis can occur at any point in the spine, but it is most common in the lower back – the lumbar spine.
Understanding lumbar spinal stenosis is easier if you learn more about the lumbar spine, which is the segment of the lower spine in the lower back. The lumbar spine is made up of 5 vertebrae located between the rib cage and the pelvis. The vertebrae form a tunnel through which the spinal cord travels, called the spinal canal. When the spinal canal tunnel is narrowed in any part of the spine, it puts pressure on the spinal cord and/or the nerves.
Left untreated, symptoms of lumbar spinal stenosis typically get worse, because the most common cause is degenerative arthritis, which is a progressive disease.
Causes of Lumbar Spinal Stenosis
Lumbar spinal stenosis is often caused by osteoarthritis, a condition caused by the gradual wear and tear of the joints as we age, which is why it’s most common in adults over the age of 50. Other conditions can cause spinal stenosis, such as a narrow spinal canal, spinal injuries, or spinal tumors.
Symptoms of Lumbar Spinal Stenosis
Often, there are no symptoms of lumbar spinal stenosis, but as the condition progresses, the symptoms come on gradually over time.
Symptoms may include:
- Lower back pain
- Sciatica (burning pain that radiates from the buttocks and through the back of the legs)
- Numbness and tingling in the legs or feet
- Weakness in the foot
- Incontinence
- Loss of sexual function
- Relief from pain on leaning forward and while resting
- Worsening symptoms over time
Lumbar Spinal Stenosis Diagnosis
To diagnose lumbar spinal stenosis, your doctor will perform a complete physical exam, take a detailed medical history, and order any necessary tests to rule out any other conditions that cause similar symptoms, such as diabetic neuropathy, peripheral vascular disease, and other conditions that mimic the symptoms of lumbar spinal stenosis. During diagnosis, your doctor will also pinpoint your degree of spinal compression.
Imaging studies that can diagnose lumbar spinal stenosis include:
- X-ray: This shows the neuroradiologist the structure of your vertebrae and the alignment of the spine.
- Magnetic Resonance Imaging (MRI): This shows the soft tissues inside the body, including the spinal cord, nerve roots, and adjacent tissues. It can detect degeneration and tumors, as well.
- Computed Tomography (CT) scan: A CT scan examines hard structures and creates images of multiple X-rays to show the shape and size of the spinal canal and the details of the bony anatomy.
Treatment of Lumbar Spinal Stenosis
For most patients, treatment begins with conservative, nonoperative therapies. Treatment may include anti-inflammatory medication, pain medication, and nerve pain medication such as gabapentin or pregabalin. Sometimes cortisone steroid injections are ordered for the lumbar spine, also known as epidural injections. This can reduce symptoms and is often repeated for maximum results. It is not a cure, but it can help manage the symptoms of lumbar spinal stenosis.
Surgery is often the best option for patients whose symptoms do not improve with non-operative treatments, or if they have severe symptoms such as progressive weakness or incontinence. Surgery is usually very successful in patients who need it to relieve leg pain, sciatica, and numbness. However, patients who have severe nerve compression for an extended length of time may have permanent loss of nerve function that cannot be recovered.
Prognosis of Lumbar Spinal Stenosis
Outlook for lumbar spinal stenosis varies, depending on the severity and duration of the patient’s symptoms and how soon the patient gets treatment. Also, the outlook depends on the patient’s response to the treatment.
New Jersey Spine Treatment Center
Our team of board-certified spinal specialists at the Brain, Spine & Neuromuscular Care Center of The Department of Neurosurgery at Rutgers Health and RWJBarnabas Health treat a variety of all types of spinal stenosis affecting all areas of the spine, including lumbar spinal stenosis. We treat thousands of patients every year who suffer from neurological conditions, and offer a multidisciplinary approach from a dedicated, board-certified team of physicians who specialize in neuroscience, from neurology to neurosurgery and beyond.
