Lumbar Spinal Stenosis

What is lumbar spinal stenosis?

Lumbar (LUM-bahr) spinal (SPI-nal) stenosis (ste-NO-sis) is a narrowing of the spinal canal in the lower back. The spinal canal runs in the middle of the spine and contains the spinal cord. Your spine is made up of many vertebrae (back bones) stacked on one another. Between each bone is a disc which serves as cushion. The spinal cord is where nerves that carry messages from your brain go to the rest of the body. When lumbar spinal stenosis happens, the nerves that go to the legs may be squeezed. With treatment, more serious problems of lumbar spinal stenosis may be prevented and your quality of life improved.

What causes lumbar spinal stenosis?

Lumbar spinal stenosis may be caused by any of the following:

• Abnormal bone development: This means that your spine may have grown abnormally, such as in scoliosis (curved spine) or dwarfism. Some people may also have been born with a narrow spinal canal.
  
  
• Degeneration: Changes in the spine and the parts around it may develop as you age. The discs between the vertebrae may bulge, slip, or lose its cushioning effect. The vertebrae may move or twist, or bone spurs may develop in them. The ligaments that connect the vertebrae to each other may thicken and cause narrowing of the spinal canal.

What are the signs and symptoms of lumbar spinal stenosis?

Spinal stenosis may occur without causing any symptoms. Signs and symptoms may include any of the following:

• Low back pain.
  
  
• Pain, numbness, tingling, or weakness of the legs that gets better when sitting down, leaning forward, or bending.
  
  
• Pain in the buttocks that extends to the thighs or legs.
  
  
• Trouble standing or walking.
  
  
• Trouble urinating or moving the bowels.

How is lumbar spinal stenosis diagnosed?

Your caregiver will need to take a detailed health history from you. A physical exam will also be done. Your caregiver will carefully check the parts of your body to look for abnormal changes or movements. He may do things to check how well you feel and how strong your muscles are. You may be asked to do certain movements, such as lift, bend, walk, sit, reach, or run. Certain tests may be done that use a special dye to help organs and structures show up better. Tell caregivers if you are allergic to iodine or shellfish (lobster, crab, or shrimp), as you may also be allergic to this dye. You may have any of the following tests:

• Computed tomography scan: This is also called a CT myelogram. An x-ray machine uses a computer to take pictures of your body. It may be used to look at your bones, muscles, blood vessels, and other tissues. You may be given dye as a shot in your back before the pictures are taken. The dye may help your caregiver see the parts inside the spinal canal better.
  
  
• 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.
  
  
• Magnetic resonance imaging: This test is called is also called an MRI. During the MRI, pictures are taken of your body. An MRI may be used to look at the muscles, joints, bones, blood vessels, or other tissues. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.
  
  
• X-ray: This is a picture of your back bones. You may be given dye as a shot into your spinal canal before the x-ray. This dye will help the bone, spinal cord, and other parts show up better on the x-ray. An x-ray to show the contents of the spinal canal using dye is called a myelogram.

How is lumbar spinal stenosis treated?

• Medicines: Caregivers may give you painkillers or steroids to decrease pain or swelling. There are medicines that help ease pain by making you feel more relaxed or help you sleep better.
  
  
• Surgery: You may need surgery if your pain cannot be controlled by other treatments. It may also be done if your weakness worsens, or bowel and bladder problems are present. Surgery by cutting a part or making a hole in the spine to open the canal may be done. The bones may also be fused together to make the spine stable.
  
  
• Therapies:
  
  
  • Occupational therapy: 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 special tools to help you with your daily activities. You may also learn new ways to keep your home or workplace safe.
    
    
  • Physical therapy: You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.
  
  
• Other treatments: These treatments may be used to help decrease your pain. You may need to rest or change your physical activities. Caregivers may use heat or ice, ultrasound, or massage. You may do specific exercises to stretch the muscles of the hip. These may include stationary bike riding, up-tilt treadmill walking, and water exercises.

Where can I find more information?

Having a lumbar spinal stenosis may be life-changing for you and your family. Accepting that you have a lumbar spinal stenosis may be hard. Contact the following for more information:

• American Academy of Family Physicians
  11400 Tomahawk Creek Parkway
  Leawood , KS 66211-2680
  Phone: 1- 913 - 906-6000
  Phone: 1- 800 - 274-2237
  Web Address: http://www.aafp.org
  

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont , IL 60018-4262
  Phone: 1- 847 - 823-7186
  Web Address: http://www.aaos.org/
  

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.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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.

Learn more about Lumbar Spinal Stenosis