Lumbar Spinal Stenosis

Lumbar spinal stenosis is a condition in which the bones and/or discs in the lower back become arthritic and push on the nerves. This commonly causes severe pain in the lower back, buttocks, and/or legs. Lumbar spinal stenosis is an often-missed diagnosis, but with a proper diagnosis, treatment can relieve symptoms and improve your quality of life.

  • Symptoms

  • Causes

  • Treatment Options

  • Pain, often severe, in the lower back
  • Pain may inhibit daily activities
  • Tingling, weakness, or numbness in the legs
  • Cramping in the legs while walking
  • Symptoms tend to worsen when walking or standing for longer than a few seconds
  • Symptoms may lessen when sitting down, flexing forward, or lying down
  • Lower back pain that is so intense that older patients must lean over a shopping cart or another assistive device to experience relief (“shopping cart sign”)
  • Symptoms usually fluctuate over time, with alternating periods of pain flareups and few or no symptoms
  • Symptoms develop slowly over time (usually found in patients over age 50)
  • Symptoms may progress and cause permanent numbness, weakness, incontinence, balance problems, or even paralysis

Frequently Asked Questions

What causes lumbar stenosis?

“Stenosis” comes from a Greek word meaning “narrowing” or “choking”. Lumbar spinal stenosis is when the tissues of the spine go through an abnormal narrowing, usually due to degeneration associated with aging. The small stabilizing facet joints between and behind the vertebrae of the spine tend to enlarge over time and compress the nerve roots in the spine. Most often, lumbar stenosis is the result of osteoarthritis and/or degenerative spondylolisthesis (slipped disc). Most affected individuals are over age 50, although in rare cases younger patients may develop lumbar stenosis due to a spinal injury or deformities such as a curvature of the spinal canal.

How can I be sure I have lumbar spinal stenosis and not another health condition?

The symptoms of lumbar stenosis are often misdiagnosed as other conditions, especially as problems or arthritis in the hip joints. A combination of a detailed medical history, symptom evaluation, physical examination, MRI, CT or CAT scan, X-rays, myelogram, and other evaluation methods can yield a proper diagnosis.

Which lumbar spinal stenosis treatment is best?

Conservative nonsurgical treatments are usually preferred by most patients if their day-to-day living is still largely unaffected. However, if your lumbar stenosis has significantly affected the quality of your life and nonsurgical treatment options have been unsuccessful, it may be time to consider a procedure. While traditional lumbar stenosis surgery (laminectomy) is the most common surgery, every patient’s symptoms, pathology, and options are unique. Dr. Pehler will carefully consider your situation before recommending the best lumbar stenosis surgery for you.

What will the surgery recovery be like?

The details of your recovery will vary depending on the surgical technique chosen. In most cases, patients can return home within 1 to 4 days. Bending and/or twisting will be restricted for the initial few weeks. Physical therapy and pain medications will likely be part of your recovery process. Practicing sitting and progressing to walking as soon as possible is encouraged to strengthen the muscles and improve circulation as the body heals. A back brace may be placed to provide support and control pain levels. Discomfort and symptoms should improve as the tissues heal. More details will be provided for you based on your surgical plan.

What are the risks of surgery for lumbar spinal stenosis? 

While all surgery poses risks, spinal stenosis surgery is a safe and effective procedure for appropriately selected candidates. Modern technology including continuous monitoring of the nerves in the spine and minimally invasive procedures lower the risks for patients. The risks, benefits, and alternatives will be discussed with you in detail with Dr. Pehler.

What are the long-term implications of lumbar stenosis?

Lumbar spinal stenosis may be progressive, but not always. This condition should be monitored carefully over time. If symptoms are manageable, conservative treatments can help maintain quality of life long-term. In cases where symptoms have progressed to the point that they are debilitating, spinal stenosis surgery can provide long-lasting relief.