Lumbar Spinal Stenosis
What is it?
Lumbar spinal stenosis is a narrowing of one of the canals in the lumbar spine. Many people with spinal stenosis have no symptoms. Sometimes however, this canal narrowing can put pressure on nerves which might result in pain, numbness, tingling or weakness in the low back or into the buttocks and legs.
What are the possible causes?
Spinal stenosis can be the result of a few different conditions. Most commonly, lumbar spinal stenosis is the result of degenerative changes in the spine. It is important to note that degeneration and arthritic changes in the body are a normal part of getting older and don’t always equate to pain. Less frequent causes of lumbar spinal stenosis include lumbar disc injury, spinal trauma, abnormal curvatures, tissue hypertrophy or overgrowth, and space occupying lesions, which might include tumors.
How is it diagnosed?
First, your doctor should give you a thorough intake interview and examination. Without the presence of any “red flags” (for example, new trauma, history of cancer, signs of infection) conservative treatment is typically recommended for at least 6 weeks.
Conservative treatment might include:
- Specific exercises
- Lumbar traction
- Lumbar spinal manipulation
- Lifestyle modifications (i.e. more frequent movement, improved sleep habits)
If pain persists longer than 6 weeks with conservative treatment then your doctor might order diagnostic imaging. Your doctor may also recommend more invasive treatments. If more invasive treatments are recommended your doctor might suggest things such as:
- Epidural steroid injections
- Pain relievers and muscle relaxers
- Spinal surgery
Can it be helped through chiropractic, PT Acupuncture?
While chiropractic care, physical therapy and acupuncture cannot undo degenerative changes in the spine, they are still effective pain treatment options. Conservative care via these avenues should be tried first when there are no “red flags” since these treatment options are safe and don’t have the same potential harmful side effects as drugs and surgery.
Is it chronic?
Lumbar spinal stenosis can become a chronic condition. While conservative treatments are often very effective in managing symptoms, they cannot undo degenerative changes in the spine. If pain persists or is severe, more invasive interventions are often recommended.
- Lurie, Jon, and Christy Tomkins-Lane. “Management of lumbar spinal stenosis.” Bmj 352 (2016): h6234.
- Weinstein, James N., et al. “Surgical versus non-operative treatment for lumbar spinal stenosis four-year results of the Spine Patient Outcomes Research Trial (SPORT).” Spine 35.14 (2010): 1329.
- Deyo, Richard A. “Treatment of lumbar spinal stenosis: a balancing act.” The spine journal 10.7 (2010): 625-627.
- Schneider, Michael, et al. “Comparison of non-surgical treatment methods for patients with lumbar spinal stenosis: protocol for a randomized controlled trial.” Chiropractic & manual therapies 22.1 (2014): 19.