Lumbar Spinal Stenosis

Spinal stenosis is a condition that describes a narrowing of your spinal canal. It can affect your upper (cervical) back, middle (thoracic) back or lower (lumbar) back. This page discusses the symptoms, causes and treatment options for lumbar spinal stenosis, which affects the five vertebra that connect your middle back and sacral spine region.

What is lumbar spinal stenosis?

The vertebra and discs that make up the spine form a hollow opening (spinal canal) around the spinal cord. Sometimes, this spinal canal begins to narrow and the spaces between vertebra become smaller. This shrinking can pinch the spinal cord and nerves, which creates pain in the back and other areas of the body. 

Arthritis is the most common reason of spinal stenosis. The breakdown of cartilage and growth of bone tissue caused by arthritis leads to painful pressure on the spinal canal. Other conditions that can cause spinal stenosis include:

• Herniated disc
• Injuries
• Tumors
• Paget’s disease

What are symptoms of lumbar spinal stenosis?

Spinal stenosis most commonly affects the neck or lower back. Individuals experience different symptoms, and some people may not have any symptoms. The most common symptoms of spinal stenosis include: 

• Low back pain 
• Stiffness in the lower back
• Numbness in the shoulders, arms or hands
• Sciatica
• Foot drop
• Difficulty walking or standing

Serious symptoms also include loss of bladder or bowel control. If you are experiencing a difficult time controlling body functions, contact your doctor immediately. 

Symptoms that interfere with your quality of life or persist over time should be evaluated by a spinal specialist to give you an accurate diagnosis and start a treatment plan that’s right for you.

How is lumbar spinal stenosis treated?

Treatment can help relieve pain caused by lumbar spinal stenosis and improve your quality of life. Your doctor will work closely with you to create a plan to help address your spinal stenosis. That may include medication, physical therapy, minimally invasive treatments, and – in some cases – surgery. 

Pain management

The goal of pain management is to help relieve your symptoms and alleviate your discomfort. Your doctor may also discuss other pain relief options, including prescription medication, cortisone injections or nerve blocks. Closely follow your physician’s instructions and read all medication labels to ensure you are taking medicine safely and effectively.

Physical therapy

Physical therapy for spinal stenosis can help strengthen your back and other parts of your body, and help you adapt every day activities to reduce painful symptoms. A therapist will work closely with you to develop exercises to do during therapy sessions and exercises you can do at home. 

Do I need surgery for lumbar spinal stenosis?

Generally, your doctor will only recommend surgery if a minimally-invasive approach does not improve pain or your quality of life. Severe cases may immediately require surgery, particularly if your spinal stenosis is making it difficult to walk or control bowel or bladder movements. 

Today, there are many advances in surgical care to help address your spinal stenosis. Your doctor will discuss which procedure is best for you: 

• Laminectomy and laminoplasty
• Foraminotomy
• Spinal fusion 
• Mazor X 

How is lumbar spinal stenosis diagnosed?

Lumbar spinal stenosis can be diagnosed with a complete examination and imaging tests, such as X-ray, magnetic resonance imaging (MRI) or computerized tomography (CT) scan. These imaging tests allow your doctor to see how vertebra are aligned and identify soft tissue damage, tumors, growths or damage to your discs or ligaments.