Overview of Lumbar Spinal Stenosis
The lumbar spine in layman's words refers to the low back. It is made up of bones known as the vertebrae through which the spinal canal runs. The spinal canal consists of the nerves that supply strength as well as sensation to our legs. Inter-vertebral discs and spinal joints can be found between our vertebrae.
As we age, the discs become less absorbent and spongy. As a result, the disc can lose height, harden and protrude into the spinal canal. In addition, arthritis may also occur that can lead to thickened and enlarged ligaments and bones of the spinal facet joints, which would all push into the spinal canal. These developments will eventually result to the lumbar spinal canal becoming narrow, a condition known as lumbar spinal stenosis.
Symptoms do not always occur with lumbar spinal stenosis. In fact, many people fail to show any symptoms despite the imaging data indicating significant lumbar spinal stenosis. When symptoms are present, they will include back and/or leg pain or numbness, leg cramps or leg weakness. Bowel or bladder disorders may occur. These symptoms usually worsen when the sufferer walks or stands for a long period, may be intermittent, and will vary in the degree of severity. The sufferer may get relief from pain when sitting or bending forward.
To diagnose lumbar spinal stenosis, the physician will take the patient's medical history and conduct a physical examination. The physician may also order x-rays to see if the discs are really narrowed or if the facet joints are thickened. In addition, the patient may also undergo an MRI or magnetic resonance imaging study, a CAT scan, or a lumbar myelogram in order to evaluate the structures of the spine in much greater detail.
There are several treatments available for lumbar spinal stenosis. Usually, it is inititally treated through non-surgical means including the prescription of anti-inflammatory and analgesic medications, physical therapy, and spinal injections like an epidural cortisone injection. The physician may prescribe a single or a combination of medications.
In addition to the above methods, the physician will also include safety considerations and modifications at home as part of the patient's treatment plan. Some examples of these would be moving certain home appliances to a more accessible place or the use of a commode by the side of the bed. The physician may also recommend the use of walking aids.
Non-operative treatments are considered first because usually lumbar spinal stenosis does not present any danger to the life of the patient, unless there is significant leg weakness, the condition worsens or there are problems with the bowel or bladder functions of the patient. Otherwise, the aim of treatment is to reduce pain and increase the ability of the patient to function normally. Only a small percentage of lumbar spinal stenosis patients will require surgery.
