Lumbar Spinal Stenosis (LSS)

spinal stenosis

The most common pre-operative diagnosis in persons over age of 65 years who are undergoing lumbar spinal surgery is Lumbar Spinal Stenosis. Although LSS can be congenital, acquire forms of LSS can be degenerative, spondylothisthetic, post-surgical, post-traumatic, or combined, with the most common cause being degenerative. Stenosis can also be seen as a result of contact sports, such as football.

 LSS can be classified as central, lateral, or combined. Central stenosis involves a narrowing of the spinal canal, while lateral stenosis affects the nerve root canal. Patients with LSS are usually at least 50 years of age, with histories of prolonged back pain and recent onset of unilateral or bilateral lower-extremity pain. The symptoms are worsened with extension of the lumbar spine or even weight-bearing postures of the spine and decreased with flexion or non-weight-bearing postures of the spine. LSS, as far as I know, cannot be corrected with exercise.

 So be careful with these seniors. Walking on the treadmill which is usually the first place you might put a senior, might cause them lower extremity pain. In such cases, the pain might be relieved by sitting in a flexed position or by inclining the treadmill to a significant degree which will increase spinal flexion. Be aware that the symptoms of a degenerative hip joint and LSS are similar and both conditions can occur simultaneously. A test you might try is the Patrick test. This is performed by laying your client supine with their hips and knees extended. The knee of the tested extremity is placed over the opposite knee bringing the tested hip into flexion, abduction and lateral (external) rotation. Pressure is applied to the medical aspect of the tested knee. Anterior groin pain or thigh pain can be considered an indication of hip joint dysfunction.

 If in doubt, refer them to another qualified Health Care Professional.