Spinal stenosis is a pathology that causes low back pain, numbness or weakness in the legs, among other symptoms. In the following, we discuss these symptoms and their severity.
Carlos is 55 years old and works as a messenger. For some time now, he has been feeling a lot of pain every time he has to get up out of his messenger van. His leg pain is so strong it forces him to stop, sit and rest. Walking has become a nightmare for him.
These types of symptoms, which lessen when you stop, sit, or rest your weight against something, are an alarm signal, as they are they are one of the main indicators that a person may be suffering from lumbar spinal stenosis. The origin of this pathology usually lies in degenerative changes in the lumbar spine, and in order to treat it, it is necessary to take into account the specific characteristics of the patient.
The lumbar canal is a very narrow channel within the lower part of the spine through which the nerves run to the legs. With the passing of time, the bone and tissue around the canal grows and causes it to become narrower. This narrowing of the spinal canal is called stenosis and it often appears in people over 50 years of age.
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What are the most common symptoms?
Symptoms usually begin when the person spends a lot of time standing, or while walking. It is considered severe if the pain appears after the patient has walked about 200 meters (218 yards), and very severe when it shows up after less than 50 meters (54 yards). Among the most common symptoms are the following:
- Leg pain
- Tingling sensation all the way down to the feet
- Back pain
- Burning pain that may radiate to the buttocks
In severe cases of lumbar spinal stenosis, the patient may suffer from partial or complete incontinence, as the nerves leading to the bladder or bowel are affected, causing them to compress. However, when the narrowing of the spinal canal does not compress the nerve structures, the stenosis may cause no symptoms at all.
If the patient suffers from a serious case of stenosis, they may show a series of characteristic symptoms, known as neurogenic claudication. The term "neurogenic" implies that the problem originates in the nerve roots and the word "claudication", which is related to limping, means that the patient suffers pain or weakness in the legs.
Although all these symptoms can help steer the specialist towards a diagnosis, in order to be certain that the patient suffers from lumbar canal stenosis, it will be necessary to carry out in-depth studies, with an MRI, CT scan, or other tests that your doctor feels are appropriate.
The severity and duration of the symptoms of spinal stenosis vary from person to person, and the treatment depends on each case. At Instituto Clavel, we study each case on an individual basis, taking into account all the characteristics of the patient in order to determine the most appropriate treatment. In the next section, we describe the treatments that are available.
Treatment options for lumbar spinal stenosis
Let's go back to Carlos. Suppose he decides to come to us in search of a way to stop the pain that is making it hard for him to do his job, and affecting his quality of life in other ways as well. Perhaps Carlos says he wants us to operate on him so the symptoms will go away. However, we will explain to him that surgery is not always the first option.
Surgery for lumbar stenosis should only be considered if the patient's ability to participate in everyday activities is significantly reduced, and if conservative treatments fail to relieve symptoms.
So, we would tell Carlos that we will begin with a less invasive treatment, based on pain relieving medication and physical therapy, implementing an exercise program that will help him strengthen his back muscles and improve posture. During this stage it will be essential to monitor his medical condition very closely to see how it evolves.
If the pain from the narrowing of the lumbar canal continues, it can also be treated with another solution, one of the most successful ones: infiltration of anti-inflammatory and analgesic medication directly into the focus of the pain. And if this is still not enough, there are other techniques such as radiofrequency or spinal stimulation.
If, after trying all these treatments, Carlos’ condition still does not improve, then it would be time to consider surgery.
Lumbar laminectomy is considered the most common surgery for lumbar stenosis, and it has a success rate of about 80%. This procedure relieves the pressure on the nerves and allows patients to get back to their normal, active life, free from pain.
Is walking good for lumbar stenosis?
Categories: Spine pathologies, Rehabilitation, Pain Management