Your spinal cord is a bundle of nerves that runs through a tunnel formed by your vertebrae. The tunnel is called the spinal canal. Lumbar spinal stenosis is a narrowing of the spinal canal in the lower part of your back. Stenosis which means narrowing, can cause pressure on your spinal cord or the nerves that go from your spinal cord to your muscles.
Spinal stenosis can happen in any part of your spine but is most common in the lower back. This part of your spine is called your lumbar area. Five lumbar vertebrae connect your upper spine to your pelvis.
If you have lumbar spinal stenosis, you may have trouble walking distances or find that you need to lean forward to relieve pressure on your lower back. You may also have pain or numbness in your legs. In more severe cases, you may have difficulty controlling your bowel and bladder. There is no cure for lumbar spinal stenosis, but you have many treatment choices.
The most common cause of spinal stenosis is osteoarthritis, the gradual wear and tear that happens to your joints over time. Spinal stenosis is common because osteoarthritis begins to cause changes in most people’s spines by age 50. That's why most people who develop symptoms of spinal stenosis are 50 or older. Women have a higher risk of developing spinal stenosis than men.
Besides osteoarthritis, other conditions or circumstances can cause spinal stenosis:
Early lumbar spinal stenosis may have no symptoms. In most people, symptoms develop gradually over time. Symptoms may include:
Pressure on nerves in the lumbar region can also cause more serious symptoms known as cauda equine syndrome. If you have any of these symptoms, you need to get medical attention right away:
To diagnose lumbar spinal stenosis, your healthcare provider will ask you questions about your symptoms and do a complete physical exam. During the physical exam your healthcare provider will look for signs of spinal stenosis, such as loss of sensation, weakness, and abnormal reflexes.
These tests help make a diagnosis:
If you have lumbar spinal stenosis, many types of healthcare professionals can help you, such as arthritis specialists, nerve specialists, surgeons, and physical therapists. Treatment can include physical therapy, medicine, and sometimes surgery. Except in emergencies, such as cauda equina syndrome, surgery is usually the last resort.
Because almost everyone has some osteoarthritis of the spine by age 50, you can’t really prevent lumbar spinal stenosis. But you may be able to lower your risk. Here are some ways to keep your spine healthy:
The best way to manage lumbar spinal stenosis is to learn as much as you can about your disease, work closely with your medical team, and take an active role in your treatment.
Keep your lower back as healthy as possible by maintaining a healthy weight, practicing good body mechanics, and getting regular exercise.
Simple home remedies like an ice bag, heating pad, massage, or a long, hot shower can help. The nutritional supplements glucosamine and chondroitin have been recommended as nutritional supplements for osteoarthritis, but recent studies have been disappointing. Ask your healthcare provider if you should try any nutritional supplements and discuss any alternative treatments or medicines you’re thinking about trying.
Lumbar spinal stenosis can cause cauda equine syndrome, which needs medical attention right away. Call your healthcare provider if you have:
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