Understanding Spinal Stenosis and Your Hurting Lower Back

spinal stenosis

Spinal stenosis presents with lower back pain and/or radiating pain into the leg(s), often referred to by physicians as lumbar radiculopathy. Usually, with spinal stenosis the referring pain going into the legs is located on both sides. Symptoms of pain usually begin at the hips and go all the way into the lower legs.

The pain associated with central spinal stenosis is the result of a compression on the spinal cord as it traverses through the spinal canal. This occurs when there is an abnormal build up of bone inside the canal which then closes in on the delicate structures of the spinal cord, including the peripheral nerves that feed the legs.

Functionally, this condition will have the most impact on activities that place the lower spine into some extension (the position of arching your lower back or otherwise known as an inward bend). These are activities that include standing, walking, and climbing stairs, to name a few. The longer the individual participates in these activities, the greater the painful symptoms become. Relief is sought by going into some spinal flexion for a period of time, such as sitting. In a flexed posture, the spaces within the spinal canal are greater and thereby reduce symptoms.

If the quality of life continues to diminish, surgery may be a viable option. An orthopedic surgeon or neurosurgeon may perform what is called a laminectomy. This involves removing a piece of the lamina from the vertebrae which in turn opens up the spinal canal and creates more space.

A physician may prescribe non steroidal anti-inflammatory medication or an external support such as a soft lumbar corset. The physician may also prescribe physical therapy with therapeutic exercises.

Therapeutic exercises can be of some benefit, and should focus on flexion patterns. Education should be to avoid repeated extension patterns. Shearing forces of the lower back should also be avoided and would include activities that place the spine into positions of rotation. Aerobic conditioning can be performed with emphasis on spinal flexion, like that of a recumbent stationary bike.

Obviously, an approach that is non surgical in nature is not as aggressive, and it will not alter the structural changes taking place in the spinal canal. It will only work to manage the condition until a more permanent solution is sought.