Back pain is a part of life. It’s sad but true. If your lower back aches and you have pain, numbness, or tingling in both legs you may be dealing with lumbar spine stenosis. It’s common and not easy to treat so here is what you need to know.
Lumbar spine stenosis (or spinal stenosis) is a back condition that can cause pain, numbness, tingling in the back, or down the legs. Weird words I know, so let me tell you a little about the back and spine to help make it clear.
Here are the basics. The back is made up of vertebrae which you can picture like a stack of bones that sit on top of one another. Each of these bones has a hole in the center. When stacked, the bones form a hollow tube (called the spinal canal) that protects the spinal cord.
The spinal cord is the bundle of nerves that connects the brain to the rest of the body and runs through the vertebrae. Nerve branches from the spinal cord pass between the vertebrae. The discs sit in between each of the vertebrae to add cushion and allow movement.
Ahhhh the muscles. You’ve all had low back muscle pain and you can make the distinction here. The muscles, tendons, and ligaments are called the "soft tissues" of the back. You know when they are sore; you can press on your aching back to feel them. Spinal stenosis is different.
Lumbar spinal stenosis is a narrowing of the spinal canal where spinal nerves pass through. This narrowing is caused by arthritis or injury. The discs can shrink and make the space between the vertebrae smaller. This can cause the vertebrae to pinch the nerves that pass through them. Ouch.
The most common symptom of lumbar spine stenosis is tingling, pain, or numbness that spreads down the legs. The symptoms usually affect both legs, but the symptoms can be worse in one leg than the other. The classic complaint for lumbar spine stenosis is that the symptoms are worse when you are walking or standing upright and they get better if you sit down or bend forward at the waist.
An MRI or a CT scan can help show what’s going on inside the back. Fancier tests like “electromyography” or “nerve conduction studies” can tell if the nerves are being compressed by the stenosis.
Options for treatment are somewhat limited. A small number of people end up needing surgery to treat a spinal stenosis but most people do well with simpler treatments. Here are your options:
- Pain medicines and muscle relaxants may help
- Injections of medicines that numb the back or reduce swelling
- Physical therapy
- Spinal manipulation by a physical therapist or a chiropractor
If that doesn’t work there are surgical options. Surgery to treat spinal stenosis involves exposing the spine and cutting away pieces of bone that are pinching the spinal cord or other nerves. The surgery can help with symptoms but there are more conservative ways to do it. One of the most important things you can do to feel better is to stay as active as possible. Even if you have some pain or discomfort, you need to be active.
Find physical activities you like to do. Take baby steps, if you have not been active for a while start by doing just a few minutes of activity a few times a week. Then you will build up to more.
- Dr. O
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