The lumbar spine is commonly referred to as the low back. The lumbar spine consists of 5 bony vertebrae. The vertebrae together form a spinal column/canal that allows the passage of the spinal cord and the nerve roots. Between each vertebrae can be found the intervertebral disc. Stenosis means narrowing. Spinal stenosis is the narrowing of the spinal canal. This causes pinching of the spinal cord and nerves resulting in back pain and leg pain. Stenosis may pinch the nerves controlling muscle power and sensation.
Causes of Spinal stenosis
o the ligaments on the bones thicken with age
o the discs between the vertebrae deteriorate pushing the vertebrae together
o the lateral (apophyseal joint) joint surfaces deteriorate
• Bony spurs may form on the bone and into the spinal canal
o you may be born with a narrowed spinal canal and therefore symptoms may present early in life
• Changes in blood flow to the lumbar spine
• Significant spondylolisthesis (slippage of a lumbar vertebrae)
Symptoms –can be bilateral – also can have spinal cord symptoms
• localized back pain and muscle spasm
• pins and needles, numbness, weakness in the legs
• difficulty walking, pain aggravated by activity
• clumsiness, frequent falling
• heavy, hot or cold feelings in the leg
Diagnosis and treatment
Spinal stenosis is often difficult to diagnose as its symptoms are much like that of other conditions. The presence of unusual leg symptoms is however a key indicator of spinal stenosis. In some cases scans may be done to see the extent of narrowing in the spinal canal.
Conservative management of spinal stenosis would include a combination of medication, rest and physiotherapy. Physiotherapy would aim to reduce pain and inflammation initially. This may include the use of electrotherapeutic modalities, soft tissue therapy, ice and heat. Physiotherapy would also involve the re-education of posture, correction of muscle imbalances and retraining of the muscle corset that provides stability to your lower back.
You may also be prescribed exercises that will help to open up the spinal canal. In some cases spinal stenosis does not respond to conservative management and surgery is required to open up the spinal canal. This would be followed by physiotherapy to restore strength and mobility to the lumbar spine.