At Temple, our team of spine specialists evaluates patients with a wide range of conditions. As a spine surgeon, one of the more common problems I help patients manage is lumbar spinal stenosis, a common cause of back pain and discomfort.
When I see patients with lumbar spinal stenosis, I take time to answer their questions and make sure they fully understand their condition — and why lifestyle changes are often the first step in easing pain and other symptoms.
Here are some answers to common questions I hear from my patients.
What is lumbar spinal stenosis?
Lumbar spinal stenosis is a narrowing of the lumbar portion of the spinal column. To understand what that means, it helps to know a bit more about the spinal column and the key role of the lumbar region.
The spinal column is a tube-shaped channel in your back that extends from the base of the skull to the pelvis. It contains your vertebrae—the bones of your spine — and spinal cord, as well as your spinal nerves, discs, and ligaments. When we talk about the spine, we often refer to specific regions, such as the cervical spine (the neck region), thoracic spine (the upper back) and the lumbar spine.
The lumbar spine is the region of the lower back just above the pelvis. It includes just five of your 33 vertebrae, but those vertebrae are the largest bones in the spine. That’s because the lumbar spine supports much of the weight of the upper body. It also houses the roots of the nerves that let you feel and move your legs and feet.
In lumbar spinal stenosis, this portion of the spinal column becomes narrow. That narrowing, or stenosis, can involve the spinal canal, the space in the middle of your vertebrae through which the nerves and spinal cord pass. Or stenosis might occur in the spaces where nerves branch out to other parts of the body.
The result of this narrowing is that the spinal nerves are compressed, causing pain, numbness, or weakness in the back and lower extremities.
What causes it?
Most people with lumbar spinal stenosis are over the age of 50. They typically develop lumbar spinal stenosis due to age-related changes to the spine's structure — essentially, wear and tear over time.
People with osteoarthritis or other degenerative conditions affecting joints have a higher risk of developing the condition. Additional causes of lumbar spinal stenosis include:
- Previous spinal injuries
- Surgeries
- Congenital
- Scoliosis (a condition that causes an abnormally curved spine)
What are some common symptoms of lumbar spinal stenosis?
People with lumbar spinal stenosis most often experience:
- Pain in the lower back and legs
- Weakness and cramping in the legs, which can limit a patient’s ability to walk normally
Some patients experience urinary issues as well.
What changes can help alleviate pain from lumbar spinal stenosis?
The pain and discomfort associated with lumbar spinal stenosis can significantly impact a patient’s quality of life. Certain lifestyle changes can help to relieve pressure on the spinal nerves, reducing pain and other symptoms.
Here are some steps I often recommend to my patients:
Get regular exercise. Physical activity can help reduce pain. Work with your healthcare team to create an exercise regimen that builds spinal strength and range of motion. This program may include swimming or cycling and alternative treatments such as yoga or acupuncture. Aim for at least 30 minutes of exercise three times a week.
Try to maintain a healthy weight. Maintaining a healthy weight can help reduce back pain by putting less stress on your back and joints.
Work on improving posture. Some people find that flexing their spine alleviates the pain and discomfort of spinal stenosis. Talk to your doctor about how to adjust your posture — both when sitting and standing — so that you are putting less strain on your back.
Don’t overdo it. Know when you might need to take a break from a certain activity. Reduce your activity levels if something worsens your pain, avoid lifting heavy objects at home or work, and ensure you exercise in a way that accommodates your condition.
Make home life as comfortable as possible. Supportive chairs and mattresses can help relieve some of the pain of spinal stenosis. Try to find the most comfortable, supportive options for your home.
What other treatments are there for lumbar spinal stenosis?
In many cases, these lifestyle changes provide significant relief for people with lumbar spinal stenosis. However, medications, braces or other physical supports, and physical therapy may help as well.
Surgery can be an effective treatment, but it’s generally recommended only for patients with severe cases and those who have not found pain relief from lifestyle changes or other treatments.
When I do recommend surgery for a patient with lumbar spinal stenosis, there are two main options, both of which can be performed with minimally invasive techniques:
Minimally invasive laminectomy is a procedure that relieves nerve compression by removing a portion of the bony vertebrae and ligaments and soft tissue that are narrowing the canal.
Minimally invasive spinal fusion involves the placement of spinal instruments to join two or more vertebrae that are causing nerve compression due to instability.
Find a solution for spinal stenosis.
If you think you may be experiencing pain from spinal stenosis, take the first step in finding relief. Request an appointment with one of Temple’s spine specialists.
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