Lumbar Spinal Stenosis

What is Lumbar Spinal Stenosis?

Lumbar spinal stenosis is a condition where the spinal canal in the lower back narrows, putting pressure on the spinal cord and nerves. This narrowing often develops gradually due to age-related changes in the spine, although other factors such as injuries or genetic conditions can also contribute. It commonly results in pain, discomfort, or weakness in the lower back and legs, significantly affecting mobility and quality of life.

Types of Lumbar Spinal Stenosis

Lumbar spinal stenosis can be broadly classified into two main types based on its cause:

Primary Spinal StenosisThis is a rare, congenital form of the condition caused by abnormal spine development present at birth. It may result in a narrower spinal canal, leading to early onset of symptoms.

Secondary Spinal StenosisThis more common type develops later in life due to changes in the spine. Key subtypes include:

• Degenerative Stenosis: The most frequent cause, often linked to age-related wear and tear, such as arthritis, thickened ligaments, or bulging discs.

• Post-Traumatic Stenosis: Caused by spine injuries or fractures that lead to structural abnormalities.

• Surgical or Treatment-Related Stenosis: Occurs as a complication of previous spinal surgeries or treatments.

• Other Causes: Conditions such as Paget's disease, tumours, or infections can contribute to spinal canal narrowing.

Symptoms of Lumbar Spinal Stenosis

The symptoms of lumbar spinal stenosis vary depending on the severity of nerve compression. Common symptoms include:

• Pain or cramping in the lower back and legs, especially when walking or standing for long periods (often relieved by sitting or leaning forward).

• Weakness, numbness, or tingling in the legs or feet.

• Sciatica-like symptoms, with pain radiating down the buttocks and legs.

• Difficulty with balance or walking due to leg weakness.

• In severe cases, loss of bladder or bowel control (a medical emergency).

Diagnosis and Treatment Options

Diagnosis: Diagnosing lumbar spinal stenosis involves a combination of clinical evaluations and tests, including:

• Detailed Medical History and Physical Examination: To assess symptoms, posture, and range of motion.

• Imaging Studies:

  • X-rays to identify structural abnormalities.

  • MRI or CT scans to provide detailed images of the spinal canal and nerves.

• Nerve Function Tests: Such as electromyography (EMG) to evaluate nerve and muscle function.

Treatment Options: Treatment depends on the severity of symptoms and the underlying cause of spinal stenosis. Options include:

• Lifestyle Modifications:

  • Avoid prolonged standing or walking, and take regular breaks to rest.

  • Incorporate exercises, such as cycling or swimming, to maintain mobility and strengthen supporting muscles.

• Medication:

  • Over-the-counter pain relievers, such as paracetamol or ibuprofen, for mild discomfort.

  • Prescription medications, including muscle relaxants or anti-inflammatory drugs, for more severe cases.

• Physical Therapy:

  • Tailored exercises to improve flexibility, strengthen the core muscles, and enhance posture.

  • Techniques such as manual therapy or stretching to relieve nerve pressure.

• Minimally Invasive Interventions:

  • Epidural steroid injections to reduce inflammation and alleviate pain.

  • Nerve blocks for temporary symptom relief.

• Surgical Interventions:

  • Required for severe cases where symptoms do not improve with conservative treatments.

  • Common procedures include:

    • Laminectomy: Removal of part of the vertebra to relieve pressure on the spinal cord and nerves.

    • Spinal Fusion: Stabilises the spine by joining two or more vertebrae.

    • Microdiscectomy: Removal of a portion of a herniated disc compressing the nerves.

• Alternative Therapies:

  • Acupuncture, chiropractic adjustments, or massage therapy for additional symptom relief.

  • Yoga or mindfulness-based exercises to manage chronic pain and improve flexibility.

Conclusion

Lumbar spinal stenosis is a common but manageable condition that can significantly impact mobility and quality of life. Early diagnosis and a personalised treatment approach are key to relieving symptoms and restoring function. At the Singapore Brain Spine Nerves Centre, we offer expert evaluation and comprehensive care tailored to your needs. If you or a loved one is experiencing back pain or related symptoms, don’t wait to seek help. Visit our centre today to take the first step towards a pain-free, active lifestyle!