Lumbar Spinal Stenosis

What is lumbar spinal stenosis?

Lumbar spinal stenosis is narrowing of the spinal canal in your lower back. Your spinal canal holds your spinal cord. The spinal cord controls your ability to move. When your spinal canal narrows, it may put pressure on your spinal cord.

What causes lumbar spinal stenosis?

  • Degeneration: As you get older, your spine and the parts around it change. Discs between your vertebrae (bones of the spine) are tough, spongy cushions that may bulge, slip, or break down. The vertebrae may move, twist, or develop bone spurs (bony growth). The ligaments that connect the vertebrae may thicken. All of these changes may cause narrowing of the spinal canal.

  • Abnormal bone development: Your spine may have grown abnormally, such as in scoliosis (curved spine) or dwarfism. You may have been born with a narrow spinal canal.

What are the signs and symptoms of lumbar spinal stenosis?

  • Low back pain

  • Pain, numbness, tingling, or weakness of the legs that gets better when you sit, lean forward, or bend

  • Pain in the buttocks that extends to the thighs or legs

  • Trouble standing or walking

  • Trouble urinating or having a bowel movement

How is lumbar spinal stenosis diagnosed?

Your caregiver will ask about your symptoms and when they started. He will ask if you have any medical conditions. He will carefully check the parts of your body to look for abnormal changes or movements. You may be asked to lift, bend, walk, sit, or reach.

  • X-rays: These are pictures of your spine that can show problems such as bulges or bone spurs.

  • CT scan: This test is also called a CAT scan. An x-ray uses a computer to take pictures of your spine. You may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell caregivers if you are allergic to iodine or shellfish. You may also be allergic to the dye.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your spine. You may be given dye to help the pictures show up better. Do not enter the MRI room with any metal. Metal can cause serious injury. Tell caregivers if you have any metal in or on your body.

  • Electromyography: This is also called an EMG. An EMG is done to test the function of your muscles and the nerves that control them. Electrodes (wires) are placed on the area of muscle being tested. Needles that enter your skin may be attached to the electrodes. The electrical activity of your muscles and nerves is measured by a machine attached to the electrodes. Your muscles are tested at rest and with activity.

How is lumbar spinal stenosis treated?

  • Medicines:

    • NSAIDs: These medications decrease swelling, pain, and fever. NSAIDs are available without a doctor's order. Ask your caregiver which medicine is right for you and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.

    • Acetaminophen: This medicine decreases pain and lowers a fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage.

    • Pain medicine: You may be given a prescription medicine to decrease severe pain if other pain medicines do not work. Take the medicine as directed. Do not wait until the pain is severe before you take your medicine.

    • Muscle relaxers: This medicine helps relax your muscles. It is also given to decrease pain and muscle spasms.

    • Steroids: This medicine is given as a shot in your back to decrease pain and swelling.

    • Nerve block: A nerve block is a shot of numbing medicine. You may need a nerve block if your pain is not going away, or is getting worse.

  • Surgery: You may need surgery to widen your spinal canal or to decrease pressure on your spinal cord. Surgery may also be done to fix damaged or injured vertebrae in your back.

How can I manage my symptoms?

  • Physical and occupational therapy: A physical therapist can teach you exercises to help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function. Occupational therapy (OT) uses work, self-care, and other normal daily activities to help you function better in your daily life. OT helps you develop skills to improve your ability to bathe, dress, cook, eat, and drive. You may learn to use tools to help you with your daily activities. You may also learn new ways to keep your home or workplace safe.

  • Rest: Rest when you feel it is needed. Slowly start to do more each day. Return to your daily activities as directed.

  • Use ice or heat as directed: Ice or heat packs on your lower back may help decrease your pain. Ask your caregiver for instructions about how to use ice and heat.

What are the risks of lumbar spinal stenosis?

You could bleed too much with surgery or get an infection. Your spinal cord or other parts of the spine may be injured. Even with treatment, the signs and symptoms of lumbar spinal stenosis may come back. If left untreated, you may develop further problems. The pain may become worse, which may affect your daily activities. You may not be able to control when you urinate or have a bowel movement. You have a slight risk of becoming paralyzed.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.

  • You have new or worsening symptoms.

  • You have a rash.

  • Your symptoms keep you from doing your daily activities.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have redness or a hard swelling in your leg.

  • You have pain in your leg that does not go away or gets worse.

  • Your legs or feet are turning blue or black.

  • You cannot control when you urinate or have a bowel movement.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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