Lumbar Spinal Stenosis

What is lumbar spinal stenosis?

Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back (lumbar spine). The spinal canal houses the spinal cord and nerves. The narrowing caused by spinal stenosis can squeeze the nerve roots in this canal, leading to pain and other symptoms.

If you have lumbar spinal stenosis, you may experience pain, numbness or weakness in the lower back, buttocks, legs and feet.

This condition is usually caused by changes due to aging, making people over the age of 50 more likely to be diagnosed.

Treatment options include medications, physical therapy, back braces, injections and surgery.

What are the symptoms of lumbar spinal stenosis?

The most common symptom is leg pain while standing or walking (the pain goes away when you sit or rest). You may also experience numbness, weakness and cramping in your lower back, buttocks, legs and feet.

Additional symptoms of lumbar spinal stenosis may include:

• Stiffness in your legs
• Fatigue or heaviness in your legs
• Pain in your lower back area
• Loss of bladder/bowel control (in severe cases)

It’s possible to have lumbar spinal stenosis with symptoms that come and go, or to not have any symptoms.

Causes of lumbar spinal stenosis

The most common cause of lumbar spinal stenosis is changes in your spine that occur as you age.

As your body ages, its soft tissues thicken, spinal discs and other joints can slowly wear down, or you may develop bone spurs, which are knobby growths that form on bone edges. These factors can all contribute to a narrowing of the spinal canal.

Conditions such as arthritis and scoliosis can worsen any type of spinal stenosis.

Diagnosing lumbar spinal stenosis

Our experts at Ohio State Spine Care use their expertise and advanced testing to differentiate lumbar spinal stenosis from other conditions that cause leg pain, such as hip joint disease or pain in your legs due to insufficient blood supply.

To confirm a diagnosis, our team may use imaging tests such as:

• Magnetic resonance imaging (MRI)
• Computed tomography (CT), with or without myelography (the use of contrast dye in the spinal fluid to study X-ray images of compression of the spinal cord and nerves)
• Electromyography (EMG), a test that measures the electrical activity of muscles
• Nerve conduction studies, usually performed with EMG to determine if a nerve is functioning normally
• X-rays

Lumbar spinal stenosis treatment

We offer treatments ranging from physical therapy to the most complex spine surgeries. Our physicians, physical therapists and other health care professionals provide you with options that increase mobility and reduce pain.

Most people who come to Ohio State Spine Care don’t need surgery.

Nonsurgical treatments

Nonsurgical treatments for lumbar spinal stenosis include:

• Physical therapy focused on stretching and strength exercises with our therapists who specialize in spine conditions
• Acupuncture
• Medication to manage your pain
• Transcutaneous electrical nerve stimulation (TENS) unit — a form of electrical stimulation that provides short-term pain relief
• Weight loss guidance, emphasizing healthier eating and exercise to ease pressure on the spine
• Steroid injections can be beneficial if other nonsurgical treatments have not been successful — they aim to reduce inflammation in the nerve root where you are experiencing pain
• Spinal cord stimulation – A device similar to a pacemaker is implanted beside the spinal cord to deliver mild electrical impulses before pain signals arrive. Instead of pain, you feel a tingling sensation.
• Bracing to limit movement and allow your body to heal
• Interspinous spacer placement

Surgical treatments for lumbar spinal stenosis

You may want to consider surgery if you’ve tried nonsurgical options for a few months and your pain is still so bad that you can’t do your normal activities.

Additionally, if you have pain with walking and have become progressively immobile, we can use either minimally invasive surgery or conventional surgical techniques for these procedures:

• Decompression surgery (laminectomy) to remove part of the lumbar vertebra and relieve pressure on your spinal cord or nerves.
• Spinal fusion surgery to fuse a severely slipped vertebra with the vertebra below it and restore stability to the spinal column.
• Minimally invasive lumbar decompression (MILD) procedure.

Most of our patients who choose surgery see positive results including significant pain relief, improved quality of life and a return to normal activities. However, your doctor will explain that surgery has some risks

including infection, nerve damage and the chance that surgery won’t alleviate your symptoms. There’s also a chance that previous symptoms may return in the future, or that you may develop new symptoms.

Research

Ohio State conducts innovative research in the laboratory, as well as through clinical trials.

Those who have a pinched nerve may be eligible to participate in one of the following areas of research at The Ohio State University Wexner Medical Center.

Biomechanical testing: We’re using biomechanical testing to assess the spine before and after surgery. A specialized vest helps us assess your spinal movement and measure the effectiveness of surgery. It ultimately may provide valuable information about which treatment methods will best increase mobility and function of the spine.

Back pain consortium: We’re members of the International Consortium for Health Outcomes Measurement (ICHOM). Membership in this elite organization allows us to engage with other top U.S. medical centers in global research studies on back pain. As we measure our results against established international standards, we share best practices and elevate our standard of care.

Enroll in a clinical trial