Lumbar Spinal Stenosis
Medical Author: Jason C. Eck, DO, MS
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
What is 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 bone 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:
In most cases the symptoms improve when the
patient is sitting or leaning forward. Typically, painful sensations shoot down
the legs with continued 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 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.
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:
Next: How is lumbar spinal stenosis diagnosed? »
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