What is Lumbar Stenosis?

Man pressing hands into the lower back area of pain

The term stenosis is medically used to describe an abnormal narrowing of an anatomic structure. Thus Spinal stenosis is the narrowing of the spinal canal through which the spinal cord and nerves travel. The lower part of the back is called the lumbar spine. Spinal stenosis in the lower back is specified as lumbar stenosis. The danger of stenosis is that it places pressure on the spinal cord and nerves within the spinal canal causing them to not function properly and causes lower back pain. It is a complicated pathology which Centers for Neurosurgery, Spine & Orthopedics can further explain as well as recommend options for treatment based on the level of severity.

What Causes Lumbar Stenosis?

The spinal cord and its nerves travel within a canal formed by the bones and joints of the spinal column from the base of the skull through the sacrum. Normally, this canal is wide enough to allow plenty of room for the spinal cord and nerves to exist essentially floating in spinal fluid without any compression or obstruction.

Narrowing of this canal usually results from degenerative, arthritic changes to the bones and joints of the spinal column. As people age, their bones and joints naturally succumb to daily wear and tear which then undergoes the arthritic process. Arthritic joints become enlarged or deformed by bone deposits, as typically seen in arthritic knuckles of the hands and fingers. When these arthritic deformities occur in the lumbar spine, overgrown joints, ligaments, or bone spurs crowd into the spinal canal resulting in lumbar stenosis which, when too narrow, places pressure on the neuronal structures within causing the patient to experience pain and functional difficulties.

Arthritic related lumbar stenosis is more common with aging. In the adult population, only about one in twenty have stenosis. However, that incidence is doubled for those over 70. Lumbar stenosis can also be caused by an injury  such as a motor vehicle accident ,   or a herniated disc.

If neural compression from lumbar stenosis becomes sufficiently advanced, electrical signals in the spinal nerves can be interrupted, and the ability of the brain to communicate with the body becomes impaired. This can result in bilateral leg pain, numbness, tingling, or even bilateral leg weakness.

What Are the Symptoms of Lumbar Stenosis?

Initially, lumbar stenosis symptoms tend to be mild, and do not require surgical intervention. Physical therapy for core and back strengthening, postural training, and skeletal stabilization slows or reverses the progression of arthritic damage and joint overgrowth. Most people with stenosis can learn to manage their symptoms effectively and prevent both reoccurrences in pain as well as the progression of the disease. However, in some instances, lumbar stenosis can become advanced, causing severe pain, weakness, or functional loss. When there is weakness or a loss of function surgery is the only solution. The surgical procedure entails enlarging the narrowed spinal canal to give the spinal cord and nerves the space they need to move freely protected within the revised spinal canal.

How is Lumbar Stenosis Treated?

When seeking treatment for lumbar stenosis, it is important to find experienced, qualified spine specialists who understand the complexities of diagnosing spine ailments. Many symptoms, such as pain or tingling, cannot be measured and may result from common conditions other than lumbar stenosis. The diagnosis of lumbar stenosis is confirmed by either a CT or MRI image. But the patient’s symptoms may or may not be due to the stenosis revealed by the images. The patient’s symptoms may be caused by other pathology which may or may not be as obvious on the images. Before any treatment decision is made, a patient’s symptoms must correlate with the location of pathology on the image. If the symptoms do not correlate, then there is no surgical solution. So, beware of providers who offer free MRI reviews and then a surgical solution without having taken a medical history or physical examination prior.

A neurosurgeon or spine surgeon evaluating lumbar stenosis must spend a great deal of time listening to patients to gather clues about the root cause of the symptoms. He or she must also conduct a detailed musculoskeletal and neurological examination. It is only thereafter that the spine specialist can make sense of a patient’s complicated MRI, with many possible abnormal findings, and determine whether any of these findings are related to the patient’s specific symptoms. The important point here is: If the initial diagnosis is incorrect, all treatment plans will fail, even if those treatments are performed well.

Up to 95% of lumbar stenosis patients will return to normal activity with physical therapy alone and without surgery. The body has a remarkable capacity for healing, and the role of the spine specialist is to guide patients through this process quickly and prevent future recurrences of symptoms.

However, for the rare patients who do need injections or surgery to regain normal function, the spine specialist must have a broad range of skills and a proven record of technical mastery to assure optimal outcomes. Patients owe it to themselves to get treatment from the best spine specialists in the field.

Contact CNSO for Evaluation, Diagnosis, and Treatment

The dedicated team at Centers for Neurosurgery, Spine, and Orthopedics (CNSO) understands how neck and back problems can impact daily life. By working with this team of renowned, board-certified neurosurgeons, orthopedic surgeons, pain management doctors, physiatrists, physician assistants, nurse practitioners, rehabilitation specialists, and certified physical therapists, patients will receive comprehensive and coordinated care. Patients will quickly resume a healthy, less painful lifestyle free from disability. CNSO offers multiple convenient locations spanning northern New Jersey, including offices in Bergen, Passaic, Morris, Essex, and Hudson Counties. Northern NJ patients can learn more about effectively treating lumbar stenosis by scheduling an appointment with the providers at CNSO today.

Centers for Neurosurgery Spine & Orthopedics