The lumbar spine (lower back) comprises five vertebrae between the rib cage and pelvis. Lumbar spinal stenosis is a spinal canal narrowing that causes nerves in the lower back and legs to be compressed.
Although it may affect younger patients due to developmental factors, it is a degenerative condition mainly affecting adults over 60.
Typically, spinal canal constriction happens gradually over many years or decades. Aging causes the disks to become less spongy, decreasing disk height and perhaps causing the hardened disk to bulge into the spinal canal.
Bone spurs and ligament thickening may also occur. They may or may not result in signs of constriction of the central canal. Symptoms may be caused by inflammation, nerve damage, or both.
Pain, weakness in the legs:Patients often complain that they have sciatica and leg pain. In many cases, the pain worsens when the patient is in flexed positions. This may do much work on limiting patients to sitting or lying in a supine position.
Pain, numbness, tingling:Depending on which nerve is affected, symptoms can vary. Sharp pain and burning sensations are common if it is an irritated nerve. If it's a spasming nerve, then ringing in the ear and numbness may occur as well as "pins and needles."
Paresthesia:These are sensations of tingling in different body parts that occur when spinal nerves are compressed.
Hip pain, knee pain:A common manifestation of spinal stenosis is sciatica. The leg pain usually improves with walking (although it might take several steps), while the hip and knee problems are more constant and often more severe.
Weakness in the legs: This can occur as a result of having both sciatica and lumbar stenosis. Numbness in the feet and weakness may also be a symptom.
Cramping in the calves:This is called fasciculation. Such cramps are typically recognized by a "twinging" or tingling sensation before the leg cramps.
Unsteadiness: This problem is typically noticed when standing and walking in a particular way. If a patient can stand and walk normally, the problem may be due to loose bones.
Tingling in the legs: This sensation occurs when nerves are compressed and with neuropathy (nerve damage). It also sometimes occurs during times of emotional stress or sexual activity.
Loss of motor functioning of the legs:This may begin in a subtle way where the patient must use both hands to lift or carry something as light as a cell phone.
Development of scoliosis:There is an association between spinal stenosis and scoliosis (curvature of the spine), but the causal relation is unclear. It's been suggested that lumbar spinal stenosis causes scoliosis by putting stress on that part of the vertebrae, which limits movement and increases stress on axial rotation. This then leads to misalignment and possible curvature.
Patients with lumbar spinal stenosis in the lower back and legs will experience the above symptoms during their lives. Many of these conditions can be treated if caught early. Onus Hospitals offers treatments for lumbar spinal stenosis.
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