(Lower back pain accompanied by achy, tingly, or numbness in the legs during walking)
Compression of the spinal nerves that leave the spine in the legs and a narrowing of the lumbar spinal canal are symptoms of lumbar spinal stenosis (the space around the spinal nerves). When you walk, this causes discomfort all the way down to your feet. Moreover, you can feel numb or weak when you move. Spinal stenosis in the lower back is more common, despite the fact that it can affect any portion of the spine (lumbar region).
Middle-aged and older adults are typically considered to be impacted by the syndrome because of how slowly it develops over time.
The five vertebrae that make up the lumbar spine are connected by intervertebral discs, which act as cushions or shock absorbers between the vertebrae. The interior of the discs is soft and jelly-like, whereas the exterior is thicker and more substantial (annulus). Facet joints, so named because they connect the bones, are covered in cartilage. The bones are joined to one another by ligaments as well. The back can move thanks to these factors, which also regulate flexibility and stability.
What is lumbar spinal stenosis caused by?
The occurrence of lumbar spinal stenosis is linked to a number of aging-related changes, including
Degenerative disc modifications
As we age, our spinal discs frequently deteriorate, becoming thinner, and sag. This disc bulging could exacerbate spinal stenosis. The jelly-like soft center (nucleus), which herniates as a result of tears in the disc's annulus, may pressure the nerves.
Ligament alterations
With time, the ligaments that connect the bones can also stiffen, expand, and thicken, which can lead to stenosis.
Facet joint adjustments
The facet joints may undergo alterations as a result of degeneration. The joints may experience fluid buildup and overgrowth (hypertrophy) (effusions). One vertebra may occasionally move forward in respect to another due to instability brought on by facet joint abnormalities, disc alterations, and ligament modifications (spondylolisthesis). This can make the stenosis worse.
Bone Cancer
Due to the continual wear and tear of osteoarthritis, the spine may unintentionally attempt to reinforce itself, resulting in tiny bone growths known as bone spurs. The nerves could potentially be pinched by these bone spurs.
What signs and symptoms point to lumbar spinal stenosis?
A common indication of spinal stenosis is pain after walking in the lower back and legs. As the spinal canal is given greater room when seated or hunched over, pain is reduced.
Other signs can include:
- Walking causes a burning sensation that spreads to the buttocks and legs, which can be relieved by resting often.
- Numbness or "loss of strength" in the legs brought on by movement that is frequently restored by rest.
- More serious issues with controlling one's bowels and bladder
- Leg weakness under stressful conditions
- Some patients may describe sciatic-related numbness and discomfort when at rest.
Not all patients develop symptoms. Why some people have symptoms more frequently than others is still a mystery.
Who is susceptible to spinal stenosis?
Women over the age of 50 are more prone to develop spinal stenosis. Also, those who have already experienced a spine injury or those who were born with a narrow spinal canal are more likely to develop this issue.
What factors are considered when lumbar spinal stenosis is determined?
A thorough evaluation is necessary since the symptoms of the condition may be confused with those of other disorders, even though spinal stenosis is commonly clinically diagnosed based on a history and physical examination. To learn more, imaging techniques like X-rays and MRI scans are frequently used. It may be helpful to assess the kind and severity of the spinal stenosis using an MRI in particular. An MRI scan can reveal the bones, discs, ligaments, joints, muscles, spinal cord, and nerves in your spine. X-rays show the skeletal layout and position of the bones in the back. A CT scan may occasionally be required to analyze the bony structures more extensively and to establish the size of any bone spurs.
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Nonsurgical alternatives
Spinal stenosis can initially be treated without surgery using techniques like physical therapy and medications if there are no new neurological symptoms (anti-inflammatory medications or painkillers). You could be inspired to give some aerobic exercises like stationary cycling or swimming a try. These endurance exercises help to keep the spine mobile while building back and abdominal muscles.
If your symptoms persist despite taking medication and receiving physical therapy, steroid injections (epidural or nerve block) may be helpful to try to prevent the need for surgery.
Operational judgments
Patients who have symptoms that worsen their quality of life and persist despite attempting alternative treatments are candidates for surgery. Also, if bowel or bladder function is abnormal or poor, surgery may be advised. During the lumbar decompressive laminotomy surgery, a portion of the thickened ligament, hypertrophic bone, and/or bulging disc are removed in order to release pressure on the nerves. Although the objective may often be accomplished with minimally invasive methods, open surgery is frequently unnecessary. A spinal fusion may be required to stabilize the spine in cases of severe spinal instability. In order to fuse the afflicted vertebrae together, titanium screws are typically inserted into the affected vertebrae, which are held together and joined by rods, along with a spacer and bone transplant into the disc gap. Most of the time, this can be accomplished using minimally invasive approaches.
Develop healthy practices to safeguard your spine.
It is advised that you exercise frequently to maintain the health of your spine. Your back muscles will become stronger with regular exercise such as walking, swimming, cycling, and weight training. Also, maintaining a healthy weight will lessen the strain on your back. The likelihood of developing spinal stenosis can be significantly decreased by maintaining excellent posture and using the right bending and lifting techniques.