Pressure on nerves in the lumbar region can also cause more serious symptoms known as cauda equine syndrome. If you have any of these symptoms, you need to get medical attention right away:. To diagnose lumbar spinal stenosis, your healthcare provider will ask you questions about your symptoms and do a complete physical exam.
During the physical exam your healthcare provider will look for signs of spinal stenosis, such as loss of sensation, weakness, and abnormal reflexes. If you have lumbar spinal stenosis, many types of healthcare professionals can help you, such as arthritis specialists, nerve specialists, surgeons, and physical therapists. Treatment can include physical therapy, medicine, and sometimes surgery. Except in emergencies, such as cauda equina syndrome, surgery is usually the last resort.
But you may be able to lower your risk. Here are some ways to keep your spine healthy:. The best way to manage lumbar spinal stenosis is to learn as much as you can about your disease, work closely with your medical team, and take an active role in your treatment. Keep your lower back as healthy as possible by maintaining a healthy weight, practicing good body mechanics, and getting regular exercise.
Simple home remedies like an ice bag, heating pad, massage, or a long, hot shower can help. The nutritional supplements glucosamine and chondroitin have been recommended as nutritional supplements for osteoarthritis, but recent studies have been disappointing. Lumbar spinal stenosis can cause cauda equine syndrome, which needs medical attention right away. Call your healthcare provider if you have:.
Health Home Conditions and Diseases. What causes lumbar spinal stenosis? Besides osteoarthritis, other conditions or circumstances can cause spinal stenosis: Narrow spinal canal Injury to the spine Spinal tumor Certain bone diseases Past surgery of the spine Rheumatoid arthritis What are the symptoms of lumbar spinal stenosis? Definition Spinal stenosis is narrowing of the spinal column that causes pressure on the spinal cord, or narrowing of the openings called neural foramina where spinal nerves leave the spinal column.
Alternative Names Pseudo-claudication; Central spinal stenosis; Foraminal spinal stenosis; Degenerative spine disease; Back pain - spinal stenosis; Low back pain - stenosis; LBP - stenosis Causes Spinal stenosis usually occurs as a person ages, however, some patients are born with less space for their spinal cord.
The spinal disks become drier and start to bulge. The bones and ligaments of the spine thicken or grow larger. This is caused by arthritis or long-term swelling.
Spinal stenosis may also be caused by: Arthritis of the spine, usually in middle-aged or older people Bone diseases, such as Paget disease Defect or growth in the spine that was present from birth Narrow spinal canal that the person was born with Herniated or slipped disk, which often happened in the past Injury that causes pressure on the nerve roots or the spinal cord Tumors in the spine Fracture or injury of a spinal bone Symptoms Symptoms often get worse slowly over time.
Symptoms include: Numbness, cramping, or pain in the back, buttocks, thighs, or calves, or in the neck, shoulders, or arms Weakness of part of a leg or arm Symptoms are more likely to be present or get worse when you stand or walk.
More serious symptoms include: Difficulty or poor balance when walking Problems controlling urine or bowel movements Exams and Tests During a physical exam, your health care provider will try to find the location of the pain and learn how it affects your movement. You will be asked to: Sit, stand, and walk. While you walk, your provider may ask you to try walking on your toes and then your heels. Bend forward, backward, and sideways. Your pain may worsen with these movements.
Lift your legs straight up while lying down. If the pain is worse when you do this, you may have sciatica, especially if you also feel numbness or tingling in one of your legs. Your provider may refer you for physical therapy. The physical therapist will teach you stretches and exercises that make your back muscles stronger. You may also see a chiropractor, a massage therapist, and someone who performs acupuncture.
Sometimes, a few visits will help your back or neck pain. Cold packs and heat therapy may help your pain during flare-ups. Treatments for back pain caused by spinal stenosis include: Medicines to help relieve back pain. A type of talk therapy called cognitive behavioral therapy to help you better understand your pain and teach you how to manage back pain. An epidural spinal injection ESI , which involves injecting medicine directly into the space around your spinal nerves or spinal cord.
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A rheumatologist will ask about your symptoms and medical history. If he suspects spinal stenosis, he will do a physical exam. Some symptoms he will look for include:.
A rheumatologist will also consider other conditions that can cause similar symptoms, such as arthritis of the hips or knees; disorders of the nervous system; or disorders of the heart and blood vessels.
A rheumatologist may also order other tests to confirm the diagnosis and determine the seriousness of your condition. These include:. Although there is no cure for spinal stenosis, regular exercise, medication and in some cases surgery can provide relief. Exercise Regular exercise can help you build and maintain strength in the muscles of your arms and upper legs the hip adductors and abductors, quadriceps and hamstrings. This will improve your balance, ability to walk, bend and move about, as well as control pain.
A physical therapist can show you which exercises are right for you. Medications Over-the-counter medications such as acetaminophen Tylenol , or nonsteroidal anti-inflammatories commonly called NSAIDs such as ibuprofen Advil, Motrin or naproxen Aleve, Anaprox , may also relieve pain.
Cortisone injections corticosteroid injections Injections directly into the area around the spinal cord known as epidural injections may provide a great deal of temporary and occasional permanent relief. There is little objective data however to support use of cortisone injections for spinal stenosis and many studies include other causes for back pain.
These injections are usually given on an outpatient basis in a hospital or clinic setting. Afterwards, doctors often perform a spinal fusion to connect two or more vertebrae and better support for the spine.
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