Lumbar Spinal Stenosis - Do I Have It?

spinal stenosis

Lumbar Spinal Stenosis is a condition which presents with pain down the legs with or without pain in the back/buttock region. Other symptoms which may be felt as well as pain are numbness, weakness and heaviness. These signs & symptoms are aggravated by walking (with walking down hill being worse than up) and leaning backwards. Whereas positions such as leaning forward or sitting slumped resting your forearms upon your thighs tend to ease the pain.

Lumbar Spinal Stenosis is caused as a result of the spinal canal, through which the spinal nerves/spinal cord passes, becoming narrowed. This narrowing is usually, although not exclusively, a result of degenerative changes. The narrowing of the spinal canal places pressure upon the spinal nerves as they pass through it and it is this which results in the signs and symptoms described above.

Further information on the causes and treatment of Lumbar Spinal Stenosis can be found in my article "Lumbar Spinal Stenosis - What is It?"

During this article, I shall explain why Lumbar Spinal Stenosis is sometimes confused with two other medical conditions: i) Sciatica and ii) Intermittent Claudication. This will help give you an indication as to whether you may be suffering with Lumbar Spinal Stenosis.

i) Sciatica: Sciatica is only a descriptive term and not a diagnostic one. It is used to describe pain which is felt down the back of the leg(s) as a result of irritation of the sciatic nerve. The sciatica I am alluding to here is musculo-skeletal sciatica, whereby pressure is being placed upon the sciatic nerve as a result of muscle imbalance, facet joint irritation or a disc herniation/bulge.

The main difference between this 'sciatic' pain and Lumbar Spinal Stenosis would be the ability to 'turn the pain off' even when it is incredibly severe.

With Lumbar Spinal Stenosis, it is quite easy to turn the pain on (lean backwards or walk down hill) as well as turn the pain off (lean forward or sit down in a slumped position/rest forward on your thighs). With sciatica of a musculo-skeletal origin, it is unlikely you would be able to turn the pain off quite so easily. In addition to this, if it was a disc bulge which was causing your sciatica, it is almost certain that leaning forward or sitting in a slumped position would aggravate your pain significantly.

ii) Intermittent Claudication: This condition is where the arteries of the legs become narrowed, causing the muscles to be deprived of the oxygen they require to carry out any degree of exercise. Therefore, when resting there may be no pain felt, but as soon as any degree of exercise is demanded of the leg muscles, pain is felt. This pain is typically felt in the calf muscles. Other symptoms which may be felt in addition to pain are tightness, heaviness, cramping, or weakness in your legs.

Whatever signs & symptoms are felt with Intermittent Claudication, they are similar to Lumbar Spinal Stenosis in that walking is a classic aggravating factor. However with Intermittent Claudication, walking up hill is usually worse than downhill. When walking uphill, there is more demand placed upon the muscles of the leg to 'power' forward (as opposed to going downhill). This increased demand on the muscles requires more oxygen and if this increased demand cannot be met, pain will be felt quicker.

With regards to walking downhill, there tends to be a tendency is to lean backwards a little and leaning backwards is a classic aggravator of Lumbar Spinal Stenosis, therefore this would aggravate your signs and symptoms quicker.

One similarity between Lumbar Spinal Stenosis and Intermittent Claudication is that both pains can be turned off quite quickly. However, the difference is that the former is turned off relative to the position of your spine i.e. leaning forwards, whereas the latter is turned off by simply having a rest, no matter what position your lower back is in.