What is Lumbar Stenosis?
Lumbar stenosis is a narrowing of the spine that puts pressure on the spinal canal and the nerves in the lower back (lumbar spine). This compression can change how the nerves function and produce symptoms of lower back pain and other sensations such as tingling or cramping in the legs, which may worsen with activity and improve with rest and change in posture. These symptoms often occur slowly or be acute exacerbations of pain.
What are the Causes of Lumbar Spinal Stenosis?
The most common cause of lumbar spinal stenosis is osteoarthritis, which is the gradual wear and tear of the joints over time. Other conditions or physical changes can cause lumbar spinal stenosis. They include:
- Repetitive or high impact injuries, including spinal fractures
- Congenital spinal stenosis
- Inherited diseases can cause those born with it
- Past surgery of the spine
- Rheumatoid arthritis
- Other diseases
What are the Symptoms of Lumbar Spinal Stenosis?
Spinal stenosis occurs over time as the nerve root is pinched (or squeezed) and combinations of symptoms occur. Symptoms may include:
- Lower back pain
- Leg pain, numbness, tingling or cramping
- Pain may radiate down the legs
- General weakness in the legs may be felt
Those with the most sever forms of lumbar spinal stenosis may experience the following symptoms:
- The loss for bowel or bladder control
- Foot disorders
- Loss of sexual function
Diagnosing Lumbar Spinal Stenosis
A complete medical history and physical examination will be conducted in order to properly determine the root of the pain and to arrive at a diagnosis of lumbar spinal stenosis or to have it ruled out. Factors that will be evaluated include:
- Family and medical history, which include past injuries
- Physical factors and lifestyle choices, such as excess weight and physical activity
- Changes in motion and instances of pain, such as painful movements, muscle weakness and sensory changes
- Results of diagnostic texts such as x-rays, MRI’s, CAT scan and bone scans
During the exam other conditions such as those associated with hip and knee arthritis, vascular diseases, neuropathy or diabetes will be ruled out.
Treating Lumbar Spinal Stenosis
The treatment options for lumbar spinal stenosis vary by the severity of the condition, the activity level and the cause of the disease. For most patients during the first 6 months after the onset of lumbar pain conservative treatment plans typically include:
- Medications to relieve pain and swelling
- Physical therapy to strengthen muscles in the back, abdominals and legs
- Modifying physical activities and stretching
If conservative measures do not relieve the pain, or it becomes acute, interventional pain management options include:
- Steroid injections to reduce swelling and pain
- Nerve blocks
- Cool Radiofrequncy ablation for facet orthoarthrist
What are the Typical Results?
Lumbar spinal stenosis treatment can be very successful for most patients in relieving the symptoms from leg pain, sciatica or radicular pain, and numbness. However, depending on the length of time and severity of the nerve compression permanent damage many not be relieved.
Results also vary by the procedure preformed. Steroid injections can provide immediate relief and may last months, requiring additional injections, or provide long-term relief when inflammation is reduced and the nerves accommodate to the space in the spinal canal. The results of Cool Radiofrequcy, if successful, usually last 6-12 months and in some cases up to 18 months or longer.