Lumbar Spinal Stenosis

What Is Lumbar Spinal Stenosis?

Lumbar Spinal stenosis occurs when the space around the spinal cord narrows. This puts pressure on the spinal cord and the spinal nerve roots, and may cause pain, numbness, or weakness in the legs.  The same condition may also affect the neck, causing similar symptoms.
low-back-spinal-stenosis-pdf-image
Degenerative Arthritis is the most common cause of spinal stenosis. When we are young, disks have a high water content , but As disks age and dry out, they may lose height or collapse. This will result in narrowing of the spinal canal,  irritation of the spinal nerves as they exit the spine, and increase load on the facet joints.

DDD

As the facet joints experience increased pressure, they also begin to degenerate and develop arthritis, similar to that occurring in the hip or knee joint. The cartilage that covers and protects the joints wears away. If the cartilage wears away completely, it can result in bone rubbing on bone. To make up for the lost cartilage, your body may respond by growing new bone in your facet joints to help support the vertebrae. Over time, this bone overgrowth-called spurs-may narrow the space for the nerves to pass through.

What Are the Symptoms of Lumbar Spinal Stenosis?

Symptoms of Spinal Stenosis are Variable, and depend on multiple factors including degree of stenosis, level of activity, other co-morbidities.  People with spinal stenosis may  have chronic low back pain, depending on the degree of arthritis that has developed. Burning pain in buttocks or legs (sciatica) is a common symptom. Pressure on spinal nerves can result in pain in the areas that the nerves supply, condition often referred Radiculopathy. The pain may be described as an ache or a burning feeling. It typically starts in the area of the buttocks and radiates down the leg.  As pressure on the nerve increases, numbness and tingling often accompany the burning pain. If the pressure on the nerve progresses,  weakness can occur in one or both legs.  Pain is usually made worse by standing up straight and walking. Some patients note that they can ride a stationary bike or walk leaning on a shopping cart. Walking more than 1 or 2 blocks, however, may bring on severe pain low back and lower extremity pain.

What Treatment Options are Available At RA Pain Services In Washington Township?

Treatment options are variable and our Physicians at RA Pain Services will provide you with an  individualized treatment plan after a thorough history, physical examination, and reviewing imaging studies. Nonsurgical treatment options focus on restoring function and relieving pain. Although nonsurgical methods do not improve the narrowing of the spinal canal, many people report that these treatments do help relieve symptoms.  Physical therapy with emphasis on stretching  and core strengthening exercises will help maintain mobility and slow down the progression.

Anti-inflammatory medications reducing inflammation (swelling) around the nerve may relieve pain.  Most people are familiar with nonprescription NSAIDs, such as aspirin and ibuprofen. Whether over-the-counter or prescription strength, these medicines must be used carefully. They can lead to gastritis or stomach ulcers. If you develop acid reflux or stomach pains while taking an anti-inflammatory, be sure to talk with your doctor. Opioid Medications such as oxycodone and Hydrocodone combinations may offer temporary relief, but are not recommended for long term use.

For Patients not responding to conservative treatments, Dr. Andrew Medvedovsky and Dr. Scott Pello may discuss epidural Injections (“Cortisone injection”).  Cortisone is a steroid, that is a potent anti-inflammatory medication that is deposited close to the nerve and and area that is source of pain,