I was diagnosed about 8 years ago with spinal stenosis. I saw a pain Specialist in August 2011; he gave me a cortisone Injection in my lower back and it worked. The shot contains a steroid an anti-inflammatory drug, which create separation of the disc and the nerve so that the pain and numbness can start to calm. When pain is decreased from cortisone it is because the inflammation has diminished. By injecting the cortisone into a particular area of inflammation, high concentrations of the medication can be given while keeping potential side-effects to a minimum. I currently take narcotic medication to treat my acute back pain. I am looking forward to round three in two weeks.
Lumbar Spinal Stenosis
The lumbar spine is made up of five vertebral bodies in the lower back. Nerves coming off the spinal cord travel though the spinal canal and exit the canal through small openings on the sides of the vertebral called foramen. Lumbar stenosis (spinal stenosis) is a condition whereby either the spinal canal (central stenosis) or vertebral foramen (foraminal stenosis) becomes narrowed. If the narrowing is substantial, it causes compression of the nerves, which causes the painful symptoms of lumbar spinal stenosis.
What causes lumbar spinal stenosis?
The most common cause of lumbar spinal stenosis is degenerative arthritis. As with other joints in the body arthritis commonly occurs in the spine as part of the normal ageing process. This can lead to loss of the cartilage between the bones at the joints, formation of spurs(osteophytes), loss of the normal height of the discs between the vertebrae of the spine (degenerative disc disease), and overgrowth (hypertrophy) of the ligamentous structures. Each of these processes reduces the normal space available for the nerves and can directly press on nerve tissues to cause lumbar spinal stenosis.
Lumbar spinal stenosis can also be caused by other conditions that decrease the space of the spinal canal or vertebral foramen. These can include: tumor, infection, and various metabolic bone disorders, such as Paget's disease of bone. These causes are much less common than degenerative arthritis.
What are the symptoms of lumbar spinal stenosis?
Lumbar spinal stenosis can cause: low back pain, weakness, numbness, pain, and loss of sensation in the legs.
In most cases the symptoms improve when the patient is sitting or leaning forward. Typically, painful sensations shoot down the legs with continue walking, and diminish with resting. Standing and bending backwards can make the symptoms worse. This is because bending forward increases the space in the spinal canal and vertebral foramen, while bending backward decrease the space. It's more comfortable for patients to sit or lean forward and are unable to walk for long distances. Patients often state their symptoms are improved when bending forward while walking with the support of a walker or shopping cart.
In most cases the symptoms gradually worsen with time. This is because degenerative arthritis is a progressive disease that gradually becomes more severe with time. If left untreated the compression on the nerves from lumbar spinal stenosis can lead to increasing weakness and loss of function of the legs. It can also lead to loss of bowel and bladder control and loss of sexual function. I haven't had any bowel problems so far...knock on wood! Your doctor can help determine if your symptoms are from lumbar spinal stenosis or a different condition. Many other disorders can cause similar symptoms including: diabetic neuropathy peripheral vascular disease, and vascular claudication.
Lumbar Stenosis Research
