Lumbar Spinal Stenosis


There are a variety of problems that occur in the back, particularly the lumbar portion of the spine, also known as the lower back. Sometimes this lower back pain is just muscle strain due to poor posture, improper lifting or a direct trauma. This type of pain is rather easily treated, especially if the pain is diagnosed and treated in a timely manner.

Sometimes however the problems plaguing the lumbar area is more persistent, lasting longer with more severe pain. Although you may still experience pain regardless of the reason, getting an accurate diagnosis immediately is crucial to making sure what you think is generic pain isn't something more severe like lumbar spinal stenosis.

What is lumbar spinal stenosis?

Lumbar spinal stenosis, commonly referred to simply as 'LSS' is a degenerative condition that causes narrowing of the spinal canal as well as spinal cord compression. Spinal stenosis may occur in any portion of the spine, but LSS affects the lower portion of the spine. Other variations of spinal stenosis may affect the cervical or thoracic, which means that the upper or middle sections of the spinal cord and canal are affected.

Symptoms of LSS

Lumbar spinal stenosis presents with some common back pain symptoms as well as a few specific to LSS. Lower back pain is to be expected with LSS but really gives the patient no indication that it is anything more than non-specific back pain.

The narrowing of the spinal cord however, can present with a pressure on the lumbar region as well as a tingling or numbness down the legs. Some LSS patients complain of muscle weakness in the legs and leg cramps. The pain associated with lumbar spinal stenosis is often the worst when walking, standing or leaning.

In some extreme cases of lumbar spinal stenosis, symptoms may include a loss of control of the bladder or bowels. The associated symptoms may not be consistently mild or severe, but if you present with two or more of these symptoms see your back specialist right away.

What causes lumbar spinal stenosis?

The primary cause for LSS is simply aging. As we age the parts of the spine may change in size or shape, often due to degeneration. LSS may be congenital but it is quite rare.

Some of the spinal changes that can lead to lumbar spinal stenosis include a thickening of the ligaments and the protrusion of the discs located between the vertebrae. Those with osteoarthritis may develop bone spurs that can push on the spinal cord, thereby compressing it.

When a vertebra slips out of its original position, a condition known as spondylolisthesis, lumbar spinal stenosis can occur as a result. Other degenerative conditions such as a herniated disc, osteoporosis or tumors can also lead to lumbar spinal stenosis.

Getting a LSS diagnosis

As with any medical condition, before treatment can occur the patient will need an accurate diagnosis. In addition to documenting a detail medical history, diagnostic tests such as x-rays, CT scans and MRI's will be used so your physician can see images of the spine. This will let them know if the spinal canal has narrowed and by how much.

Additionally you will be tested for a loss of movement to any degree, which can help determine what type of imaging will be needed for diagnosis. A physical exam will tell your doctor how far your LSS has progressed and what treatments are available.

Treating lumbar spinal stenosis

After a LSS diagnosis your physician will recommend a variety of different treatments for different symptoms.

Initially, in fact even before your initial doctor's visit, it is recommended that you exercise and make use of heat packs to relax muscles and relieve pain. This, along with over the counter pain medication, is just a temporary fix to help make the days before your diagnostic tests bearable.

Physical therapy and exercise are often part of a lumbar spinal stenosis treatment plan to increase the flow of oxygen-rich blood to the muscles in the lumbar region of the spine. Massage therapy also serves this purpose, but the results don't last quite as long.

Be sure to ask your back specialist about alternative treatments for LSS as they are often as effective as mainstream techniques. Additionally these treatments may work well enough that a risky and costly surgery is unnecessary.

Alternative treatments for LSS may include:

  • Electrical stimulation
  • Muscle balance therapy
  • Far-infrared heat
  • Trigger point therapy

Not every patient will respond the same to traditional or alternative treatments, which is why it is recommended that you try as many treatments as possible. If after six weeks the treatments have proven unsuccessful, work with your physician to come up with a different combination of treatments.

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