Lumbar spinal stenosis is a condition that causes low back and leg pain. When severe, it can diminish daily quality of life. Spinal stenosis is most often connected to the aging process. Yet, other factors like genetics, smoking, and diabetes can contribute.
Symptoms of Lumbar Spinal Stenosis
The word “stenosis” is a medical term that means narrowing. In lumbar spinal stenosis, there’s narrowing of the spine in the lower back due to tissue overgrowth. Stenosis compresses the nerves that run from the brain to the feet causing pain, fatigue, and weakness in the legs. These symptoms are worse when standing or walking because the overgrown tissues bulge and squeeze on the spinal nerves when you are upright. It’s a symptom known as claudication.
Relief can be temporarily found by leaning over a shopping cart or walker because that position stretches out the tissue, gives the nerves more room to “breathe” and thereby relieves the pain. People with lumbar spinal stenosis tend to sit a lot because they don’t hurt while seated. But sitting all the time limits people’s function in day-to-day life and that is not sustainable for most individuals.
Some people who suffer from vascular disease also experience the same symptoms. So, it’s important to get the right diagnosis.
Treatment Options
Some individuals attempt to “tough it out,” but the pain and weakness can limit daily function. For example, people may struggle to make it through a trip to the grocery store without having to take a break to sit.
Physical Therapy
The general treatment approach for stenosis begins with the most conservative treatment. A good first place to start is activity modification combined with physical therapy. Becoming stronger often reduces symptoms.
Pain Relievers
Over-the-counter pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol) may also provide relief. Check with your health care provider before taking pain relievers as they can interfere with some prescription medications and certain health conditions. If those options do not provide enough relief, prescription medication may enter the equation.
Epidural Injections
Another option is an epidural steroid injection. In the epidural injection, patients have an anti-inflammatory medicine injected into the tight area of the spine. This doesn’t “cure” the stenosis, but it makes the nerves less irritable and reduces the pain. Injections can be repeated over time if they are helpful for long enough. Many patients respond well to this treatment but if pain still persists, doctors may recommend surgical intervention.
Surgery
Surgery only becomes necessary when pain is overwhelming. For example, if function is so limited that people are not able to meet their desired quality of life. While rare, some people begin to experience a “foot drop” or urinary/fecal incontinence. In that case, surgery may be the next step.
Traditionally a laminectomy is done, removing the bones and ligaments and relieving the nerve compression. But a minimally invasive approach is now available for many people.
MILD: A New Surgical Option
Minimally invasive lumbar decompression (MILD) is a new approach. MILD does not remove the bone but does trim away the ligament that causes much of the problems. Without the overgrown tissues, the spinal cavity is opened up and reduces the pressure on the nerves. MILD is an outpatient procedure that takes about 30 minutes to do and has a high success rate.
While MILD doesn’t cure lumbar spinal stenosis, it can provide tremendous relief.
By getting treatment, whether it be over-the-counter pain relievers, physical therapy or minimally invasive surgery, the relief provided gives people the ability to resume their daily activities and regain quality of life, walk to and from the car, watch their grandchildren play soccer, and so much more. With many treatment options available, a good quality of life is just around the corner.
Listen to a Podcast
Non-Operative Treatments of Low Back Pain from Lumbar Spinal Stenosis
Lumbar Spinal Stenosis usually shows up as pain when walking or standing, but feels better when bending over or sitting. This is generally caused by nerve compression in the lower back. While this kind of low back pain can have a very negative impact on your life, there are great treatment options so you can get relief quickly! In this podcast, Dr. Brian Block, a pain management expert at Maryland Pain Specialists and UM St. Joseph Medical Center, talks about treatments for lumbar spinal stenosis, especially alternatives to surgery. Download a copy or watch the video below.
More to Read
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- Preventing Low Back Pain During the Holidays
- Solutions to Manage Nighttime Back Pain
- How to Relieve Back Pain Without Surgery
Medically reviewed by Brian Block, MD, PhD.
