This post was written based on a recent appearance by Alan McGee Jr., MD, PPG – Orthopedics, on the television program PBS HealthLine.
An orthopedic spine surgeon explains what lumbar spinal stenosis is, what causes the discomfort of the disorder, and the best options for treatment and prevention.
What is lumbar spinal stenosis?
Lumbar spinal stenosis is an abnormal narrowing of the spinal canal in the lower part of the back. This tapering can place pressure on the spinal cord or the nerves that run from the spinal cord to the muscles. Spinal stenosis can happen anywhere in the spine, but it is most common in the lower back or lumbar spine, resulting in back pain.
What causes lumbar spinal stenosis?
The most common cause of lumbar spinal stenosis is the gradual wear and tear that happens in the spine due to arthritis or, more specifically, osteoarthritis. Most people who develop symptoms of lumbar spinal stenosis are 50 years of age or older. As you age, the changes in your spine become more evident, and symptoms manifest over time.
What are the most common symptoms associated with the condition?
Some people with lumbar spinal stenosis have no symptoms, while others with the condition could experience pain, cramping, tingling, weakness, fatigue or numbness in the back, legs, feet or buttocks. Also, depending on the pressure being placed on the nerves, a person’s symptoms could worsen over time.
How is lumbar spinal stenosis diagnosed?
In most cases, your physician or a specialist can diagnose lumbar spinal stenosis by discussing the history of your symptoms, doing a physical exam and ordering imaging tests. Your MRI, CT scan and X-ray results will help rule out other problems and confirm if you have stenosis.
How is lumbar spinal stenosis typically treated?
For the majority of patients I see, even those with lumbar stenosis, surgery is the last resort. I don't automatically jump straight to surgery. Yes, I am a spine surgeon, but if I can help treat or heal my patients with non-operative modalities, that's where I like to start. Treatment for lumbar spinal stenosis can include any of the following options:
- Physical therapy
- Anti-inflammatory/non-steroidal medications
- Muscle relaxants
- Prescription medications
- Neuropathic medications
- Epidural spinal injections
The most common prognosis for patients experiencing a flare-up of acute or chronic back pain is to get better with any of the above non-operative treatments. Someone going through a bout can take a short course of anti-inflammatory medications. However, you must speak with your primary care provider before doing so because anti-inflammatory and non-steroidal medicines can cause high blood pressure, kidney issues, upset stomach and ulcers. If your provider gives you the okay, 4-6 weeks of treatment could help calm down the inflammatory process, allowing your body to reset.
Can lumbar spinal stenosis be prevented?
While there isn’t a single way to prevent lumbar spinal stenosis, strengthening your core muscles, maintaining a healthy weight, and focusing on proper posture and body mechanics can help delay and lower your risk of developing the condition.
At what point should someone seek help for lumbar spinal stenosis?
You should call your physician if:
- You have pain severe enough to restrict your daily activities or movement
- You have fallen, especially following surgery
- You have a fever
If you have additional questions or need expert care for lumbar spinal stenosis, the physicians and specialists at Parkview Physicians Group - Orthopedics can help. For more information or to request an appointment, please call 260-484-8551.