Depending on where in the spinal column it manifests, spinal stenosis can be an extremely serious condition. Lumbar (low back) spinal stenosis involves the compression of spinal nerves that run along the spinal column. Spinal nerve compression typically causes decreased mobility accompanied by very sharp lower back pain. This type of spinal nerve compression also produces sciatica, which is normally a radiating or shooting pain down one or both of the legs. Lumbar spinal stenosis is normally less serious, given that the spinal cord is not at risk for compression. Cervical spinal stenosis, however, is potentially far more dangerous. The cervical spinal cord can be compressed, causing nerve damage and, if left untreated, paralysis. When a patient experiences lumbar spinal stenosis, symptoms of pain in the lower extremities typically increases when standing or walking, but improves when sitting. This is because the ligamentum flavum, which is the “yellow” ligament which lies behind the nerves, buckles when standing, but stretches and therefore thins when bending or sitting, thus thinning out and relieving pressure on the nerves in the lumbar spine. The pain which a patient experiences in the legs when standing is different than the pain of “vascular claudication” which is pain in the lower extremities which occurs when a patient is walking. This vascular claudication or leg pain results from increases activity of the muscles of the legs, without adequate blood supply to the muscles, because of narrowing of the arteries feeding the muscles in the leg.
There are several different possible causes for spinal stenosis, and physicians will normally need to conduct imaging tests (CT scans, magnetic resonance imaging MRI , and X-rays) to determine the best course of treatment. Excessive bone growth, herniated (slipped) spinal discs, tumors, overly thick spinal ligaments, and physical trauma can all potentially cause spinal stenosis. Since these problems may need corrective surgery, physicians may require several tests to ensure an accurate diagnosis. In the case of spinal tumors, this will often include a biopsy to determine whether the mass is malignant, as well as if the cancer has spread to other regions of the body.
Surgery to correct lumbar spinal stenosis is typically called a decompressive lumbar laminectomy, which is a surgery of the lumbar spine to remove the back of the spine, the lamina and spinous processes, and remove the ligamentum flavum, to give the nerves more room, and take away pressure on the nerves.
Several medications, such as anti-inflammatories, muscle relaxants, and pain relievers, will often be administered during post-operative care. Physical therapy will also form a cornerstone of a patient’s recovery from spinal stenosis. Physicians typically prescribe a regimen of core strengthening exercises to build up the network of ligaments, muscles, and tendons around the spinal column in order to maximize their ability to assist the spine in bearing the stresses of movement. Increased blood flow and nutrition from aerobic activity will also help in maintaining optimal core strength. Patients should complete their entire physical therapy regimen, as well as adopting long-term core strengthening exercises to lower pain levels and reduce the possibility of subsequent back surgeries.
Spine experts at the Kraus Back and Neck Institute have significant experience treating patients with lumbar spinal stenosis and cervical spinal stenosis. Patients are treated from Houston and the surrounding areas, including Woodlands, Sugarland, Katy, Humble, Kingwood, Memorial City, Beaumont and Port Arthur.
“So don’t live in fear and pain.” Come see the experts at the Kraus Back and Neck Institute in Houston, TX.
KRAUS BACK AND NECK INSTITUTE VIDEO, DR GARY KRAUS AND DR MASAKI OISHI
Keywords: spinal stenosis, lumbar stenosis, spinal nerve, physical therapy, core strength, low back pain, leg pain, Houston, Woodlands, Sugarland, Katy, Humble, Kingwood, Memorial City, Beaumont, Port Arthur