Spinal stenosis is the compression of spinal nerves caused by narrowing of the spinal canal and it is one of the common causes of low back pain. Spinal stenosis can also affect the spine in the neck region. The symptoms include back pain, burning or aching type of pain in the buttocks that radiates to the legs (sciatica), weakness in the legs or "foot drop”. One of the causes for spinal stenosis is ageing and other causes include Paget’s disease, achondroplasia, spinal tumors and spinal injuries. As age advances the chances of developing osteoarthritis, disc degeneration and thickening of ligaments may increase and these conditions cause spinal stenosis.
Lumbar spinal stenosis may be treated with conservative treatment approaches such as use of pain medications, physical therapy, steroid injections or acupuncture. In chronic cases, surgery may be required to treat the condition.
- Physical therapy: Physical Therapy involves stretching exercises, massage, and lumbar and abdominal strengthening.
- Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs) initially provide pain relief and reduce swelling.
- Steroid injections: Cortisone steroid injections are given around the nerves or in the "epidural space” to decrease swelling and pain.
- Acupuncture: Acupuncture can be helpful in cases where the pain is less severe.
- Chiropractic manipulation: Chiropractic manipulation can be done in some cases but not when there is co-existing osteoporosis or herniated disc because these cases increase the symptoms or cause injuries.
Surgery is considered for patients in whom the pain and weakness is causing debilitation such as inability to walk for a long time. The two main surgical procedures to treat lumbar spinal stenosis are laminectomy and spinal fusion.
- Laminectomy: This procedure involves removal of the bone, bone spurs, and ligaments that compress the nerves.
- Spinal fusion: In this procedure, two or more vertebrae are permanently fused together.