Page Updated on Apr 2, 2020 by Dr. Reyfman (Pain Management Specialist) of Pain Physicians NY

What is Spinal stenosis?

Spinal stenosis is a medical disorder characterized by a narrowing of the spinal canal. Many factors can lead to spinal stenosis like, for example, degeneration of the spinal column and intervertebral discs, bone spurs, trauma and injuries to the spinal column, etc.spinal stenosis doctors brooklyn pain management specialists

Problems with the spinal cord will affect virtually everyone as we get older, but the severity of the symptoms will depend on its cause, location, and size of the person’s spinal canal.

Spinal stenosis can affect almost every part of the spine. However, spinal stenosis is more common in its lumbar and cervical part.

What are the causes of Lumbar spinal stenosis?

As mentioned, lumbar spinal stenosis is the narrowing of the spinal canal in the lumbar part of the spine. Some people are even born with a narrow spine canal, known also as congenital spinal stenosis. The most common causes of lumbar spinal stenosis include:

  • Herniated disc – it is well known that the vertebral column consists of vertebrae that are separated from one another by cartilage discs. These cartilage discs work like cushions and shock absorbers for the vertebral column. In cases of any injuries of the back or degenerative diseases that affect the discs, making them weak or even tear, the center of the discs pops out, compressing the spinal nerves.
  • Spinal injuries – like car accidents, or any other major trauma of the spine
  • Thickened ligaments – ligaments can become stiff and thickened over time, narrowing this way to the spinal canal.
  • Overgrowth of the bone – bone spurs can grow due to osteoarthritis. These bone growths will put pressure on the spinal cord and the nerve roots. Paget’s disease is another medical condition, affecting adults, which is characterized by overgrowth of the bones, including also the spine.
  • Tumors – abnormal tissue can grow inside the spinal cord, narrowing this way the spinal canal.

What are the signs and symptoms of lumbar spinal stenosis?

The signs and symptoms of lumbar spinal stenosis start gradually and they intend to get worse over time. Some people with degenerative diseases of the spine have no signs and symptoms at all, while others may have mild discomfort in the lower back. However, others may not even be able to walk. The severity of the signs and symptoms of lumbar spinal stenosis always depends on the stenosis itself, its location, its cause, and the individual pain tolerance.

Once present, the signs and symptoms of lumbar spinal stenosis usually include pain in the lower back, buttocks, thigh or leg with tends to get worse when standing or walking, numbness, tingling, muscle weakness, weakness in the lower extremities, etc.

How is Lumbar spinal stenosis diagnosed?

The diagnosis of lumbar spinal stenosis begins with a complete medical history and physical examination. It is very important to determine which symptoms are present, what makes them worse or better and for how long they have been present. During the physical examination, it is also important to determine if there is any muscle weakness or numbness in the lower part of the body, sometimes even accompanied by bowel and bladder incontinence. If during the neurological examination, abnormalities in the strength and sensation are found, chronic nerve root compression is present.

This causes inflammation and pain often accompanied also with numbness of the affected leg, due to the fact that the sciatic nerve becomes pinched, this condition known as sciatica, it causes sciatic nerve pain.

No laboratory tests can help diagnose lumbar spinal stenosis. However, imaging tests like X-rays, CT – scan and MRI help visualize the spinal canal, the presence of the spinal stenosis and the degree of the narrowing.

How is Lumbar spinal stenosis treated?

Lumbar spinal stenosis treatment depends on its cause, the severity of the signs and symptoms and how this medical condition limits the everyday activities of the affected person.

Treatment can be divided into non – surgical and surgical treatment. Non – surgical treatment consists of various medications for controlling the pain, physical therapy, and steroid injections such as Cervical Epidural Steroid Injections, and Lumbar Epidural Injections which tend to reduce the inflammation, leading this way into a relief of spine compression and nerve root compression.

Surgical treatment is considered as the last treatment option when all the other conservative treatment options have failed to control its signs and symptoms. The goal of the surgical treatment is to decompress the spinal cord and the nerve roots, by enlarging the spinal canal. Minimally invasive options include the Vertiflex and MILD procedure.

We always consider non-invasive treatment options first before we turn to more invasive procedures like minimally invasive surgery.