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Lumbar Stenosis

Lumbar refers to the low back. Stenosis means narrowing of the passageways that nerves travel through. Stenosis (narrowing) only draws my attention when it starts affecting the nerves of your low back. When this happens, you will experience low back pain and/or radicular (radiating) leg pain.  

lumbar stenosis

There are two very common conditions that occur when lumbar nerves are pinched: umbar radiculopathy and neurogenic claudication.

Lumbar radiculopathy refers to the abnormal sensations (including leg pain) and weakness in the legs from a pinched or damaged nerve in the lumbar spine. Common manifestations include sharp, achy, stinging, dull, electrical, throbbing or burning pain down the legs.  Numbness and tingling are common complaints.  Muscle weakness (particularly Foot Drop) occurs during extreme nerve damage.

Claudication means “limping” in Latin. Generally, it refers to a walking impairment described by pain, numbness, tiredness, weakness and falling. Usually, pain predominates and the other symptoms emerge when walking continues without sitting to relieve the pain. The neurogenic aspect of this condition refers to pinched nerves as the origin of the problem. The reason that the nerve is pinched when you stand is because the lumbar spine changes shape when you move from a sitting position to a standing position or back to a sitting position (the nerves have more room when you are sitting and less room when you are standing). This is true for everyone, but when the spine narrows around the nerves, there is less margin to protect the nerves.

The treatment course for lumbar stenosis begins with conservative care.  Usually minor cases can be managed with anti-inflammatory medications. More moderate cases require therapy and narcotic medications.  Severe cases might require epidural cortisone injections or even surgery.


Corrective surgery is aimed a taking the pressure off of the nerve.  Removal of the compressing tissues is often curative.  This might involve shaving part of the disc, small ligaments and/or bone spurs surrounding the compressed nerves.

Lumbar stenosis is primarily a disease of an aging population.  It is the most common spine disease of the elderly requiring spine surgery.  Accordingly, lumbar decompression surgeries have been the most commonly performed surgeries of the geriatric spine.

 

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