What is Lumbar Spinal Stenosis?
For older adults, one common cause of lower back pain is lumbar spinal stenosis (also known as LSS). LSS is an anatomic condition in which the narrowing of the central canal, lateral recess, and/or neural foramen, compressing the nerves, and causing pain, weakness, and numbness in the lower back, buttocks, and legs.
The lumbar spine refers to the set of five (sometimes six) vertebrae between the ribcage and the pelvis. Imagine that these vertebrae are a series of tubes, with little holes poked down the sides. The spinal cord or spinal nerves run from the base of the neck, down behind the ribcage, and then it branches off into individual nerve roots when it reaches the lumbar spine. The nerve roots thread into the “tubes” and exit the spinal canal through the little “holes,” called foramina.
The nerve roots transmit sensations and motor signals between the brain, the pelvic muscles, and the lower extremities. Normally, there is plenty of room inside the spinal canal for all of the nerves to function properly.
Now, imagine that the space inside the tubes gradually becomes narrower and narrower. As the walls close in, they start to pinch that bundle of nerves. That compression causes pain and makes it much more difficult for the nerves to do their job. This progressive narrowing can lead to low back and leg pain, weakness, loss of sensation in the legs, and loss of bowel or bladder control.
What Causes of Lumbar Spinal Stenosis (LSS)?
What causes the progressive narrowing of the spinal canal? We see this in some patients who’ve had a spinal injury, a tumor, or a herniated disc. However, the natural history of LSS suggests the most common causes would be degenerative arthritis and degenerative disc disease.
Older American adults are more susceptible to arthritis due to normal wear-and-tear on the vertebrae. Over time, the cartilage that cushions the vertebral (facet) joints wears thin, and the bone tissue starts grinding together, causing pain. The bony tissue responds to this friction by forming bone spurs, which protrude into the spinal canal, constricting the available nerve space.
Osteoarthritis can also contribute to degeneration of the discs between the vertebrae, and thickening of the ligaments. This can increase the risk of one vertebra “slipping” onto another, called degenerative spondylolisthesis. All of these complications reduce the amount of space in the spinal canal and put unwelcome pressure on these crucial nerves.
Lumbar Spinal Stenosis Symptoms
Signs and symptoms of LSS include:
- Radicular pain
- Low back pain
- Radiating leg pain
- Weakness in the lower back and legs
- Numbness in the legs and feet
- Pins and needles sensations
- Loss of bowel control
- Urinary incontinence
- Sexual dysfunction
Usually, painful symptoms improve when the patient is seated or leaning forward – this position opens the spinal canal – and worsen when standing or leaning backward. Walking can cause shooting pain through the legs, which subsides with rest.
Lumbar Spinal Stenosis Treatment
LSS can be effectively treated using minimally-invasive and nonsurgical treatments. At Nuvo Spine, we choose conservative treatment options that reduce pain and improve physical function.
Your treatment plan will be custom-tailored to your needs, and may include a combination of the following:
- Spinal stenosis physical therapy.
- NSAIDs (non-steroidal anti-inflammatory drugs).
- Epidural steroid injections for spinal stenosis.
- Platelet-rich plasma injections – harnesses the body’s own regenerative healing powers.
- Hydrodisectomy – water jets wash away herniated disc tissue.
If you suffer from lower back pain and to avoid invasive spine surgery, visit our office to learn what our award-winning pain management specialist can do for your quality of life and pain relief. Findings taken from your medical history and physical examination (along with the anatomic demonstration of stenosis with an MRI or CT scan), will establish a proper diagnosis of LSS. Nuvo Spine offers a variety of advanced conservative treatments with follow ups for LSS patients including the latest cutting-edge minimally-invasive techniques without a need for surgical treatment.