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OVERVIEW

What is lumbar spinal canal stenosis?

The lumbar spinal canal is the space inside the lower spine that carries nerves to your legs. It is very narrow. Over the course of many years, the bone and tissue around the canal grow, causing the canal to become even more narrow. This narrowing is called “stenosis.” As this happens, the nerves that go through it are squeezed. This squeezing may cause back pain, leg pain and weakness.

Is lumbar spinal canal stenosis the same as a ruptured disk?

Lumbar spinal canal stenosis is not the same as a ruptured disk. A ruptured or “herniated” disk usually pinches 1 or 2 nerves at a time. The pain caused by a ruptured disk in the lumbar spine is usually easy to diagnose and is known as sciatica. Sciatica usually causes back pain that shoots down one leg along the path of the sciatic nerve. Sciatica can happen any time, not just when you stand up or start walking like it does with stenosis.

SYMPTOMS

People who have lumbar spinal canal stenosis may have back or leg pain or numbness. Your legs might also feel cramped, tired or weak. These symptoms usually start when you are standing or walking.

Many people notice the pain is better climbing stairs or leaning over a shopping cart and worse walking down stairs. Often, the symptoms get better if you sit, crouch, or lie in the fetal position (with your knees tucked up to your chest). It’s thought that these positions “open” the lumbar canal and take the pressure off the nerves that go to the legs. In severe cases, stenosis can cause partial or complete bowel or bladder incontinence.

CAUSES

What causes lumbar spinal canal stenosis?

Lumbar spinal canal stenosis may happen on its own over time. This is because your bones and other tissues continue to grow around the canal. This growth makes the canal narrow over the course of your life. Other causes of lumbar spinal canal stenosis include:

• Arthritis
• Falls
• Accidents
• Wear and tear on the spine’s bones and joints

DIAGNOSIS & TESTS

How is it diagnosed?

Sometimes your healthcare provider can tell if you have stenosis by asking you about your symptoms. Your healthcare provider may also order special tests and X‑rays of the spine to make the diagnosis.

PREVENTION

Lumbar spinal canal stenosis cannot really be prevented because it seems to be a part of getting older. Healthcare providers don’t know why certain people develop it. But you may be able to reduce your risk by exercising regularly, maintaining a healthy weight, and using good posture.

TREATMENT

What can I do to relieve the pain and numbness?

Your treatment will depend on how bad your symptoms are. If your pain is mild and you haven’t had it long, you can try an exercise program or a physical therapy program. This can strengthen your back muscles and improve your posture.

Your healthcare provider may also prescribe medicine to help reduce inflammation (soreness and swelling) in your spine.  If you have more severe symptoms, you may need to see a spine surgeon. The surgeon may recommend an operation to take the pressure off the nerves in your lower spine. This surgery works well for many people.

Living with lumbar spinal canal stenosis

Lumbar spinal canal stenosis symptoms may come and go, especially at first. If you’ve noticed discomfort in your back and legs, talk to your healthcare provider. These early symptoms are often easily managed through exercise.

The longer you have lumbar spinal canal stenosis, the more likely you’ll have symptoms that are more noticeable. You may be able to manage the symptoms by taking medicine or you may need only a heating pad. Work with your healthcare provider to decide which strategy is best for you.