Lumbar Spinal Stenosis
Lumbar spinal stenosis is one of the common causes of low back pain. It is caused by the narrowing of the spinal canal which occurs as a part of aging process. The symptoms include back pain, burning or aching type of pain in buttocks that radiates to the legs (sciatica), weakness in the legs or “foot drop”. Lumbar spinal stenosis may be treated with conservative treatment approaches such as use of pain medications, physical therapy, steroid injections, or acupuncture. In chronic cases, surgery may be required to treat the condition.
- Physical therapy: Physical Therapy involves stretching exercises, massage, and lumbar and abdominal strengthening.
- Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs) initially provide pain relief and also reduce swelling.
- Steroid injections: Cortisone steroid injections are given around the nerves or in the “epidural space” to decrease swelling and pain.
- Acupuncture: Acupuncture can be helpful in cases where the pain is less severe.
- Chiropractic manipulation: Chiropractic manipulation can be done in some cases but not when there is co-existing osteoporosis or herniated disc because these cases increase the symptoms or cause injuries.
Surgery is considered for patients in whom the pain and weakness is causing debilitation such as inability to walk for a long time. The two main surgical procedures to treat lumbar spinal stenosis are laminectomy and spinal fusion.
- Laminectomy: This procedure involves removal of the bone, bone spurs, and ligaments that compress the nerves.
- Spinal fusion: In this procedure, two or more vertebrae are permanently fused together.