Illness & Conditions - Health Conditions
Lumbar Spinal Stenosis
Is this topic for you?
This topic is about spinal stenosis of the lower back, also known as the lumbar area. If you need information on spinal stenosis of the neck, see the topic Cervical Spinal Stenosis.
What is lumbar spinal stenosis?
This usually happens when bone or tissue—or both—grow in the openings in the spinal bones. This growth can squeeze and irritate nerves that branch out from the spinal cord .
The result can be pain, numbness, or weakness, most often in the legs, feet, and buttocks.
What causes lumbar spinal stenosis?
It's most often caused by changes that can happen as people age. For example:
What are the symptoms?
Symptoms may include:
Symptoms may be severe at times and not as bad at other times. Most people aren't severely disabled. In fact, many people don't have symptoms at all.
How is lumbar spinal stenosis diagnosed?
Your doctor can tell if you have it by asking questions about your symptoms and past health and by doing a physical exam.
How is it treated?
You can most likely control mild to moderate symptoms with pain medicines, exercise, and physical therapy . Your doctor may also give you a spinal shot of corticosteroid , a medicine that reduces inflammation.
You may need surgery if your symptoms get worse or if they limit what you can do. Surgery to remove bone and tissue that are squeezing the nerve roots can help relieve leg pain and allow you to get back to normal activity. But it may not help back pain as much.
Frequently Asked Questions
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The most common cause of lumbar spinal stenosis is changes in the spine that can happen as you get older.
Spinal stenosis usually happens gradually. Symptoms may start when the changes begin to squeeze the spinal cord or its nerve roots .
These age-related changes often happen when you have certain disorders:
Also, other conditions may cause spinal stenosis, such as:
Many people, especially those older than age 50, have some narrowing of the spinal canal but don't have symptoms.
Symptoms occur when the nerve roots get squeezed.
The most common symptom is leg pain that happens when you walk or stand and feels better when you sit. You feel pain in your legs, because the nerve roots that pass through the lower spine extend to the legs.
People often have leg pain when the spine is extended—when they are standing straight or leaning backward, for example.
And they often feel better when the spine is flexed—when they are sitting, walking uphill, riding a bicycle, or leaning over a grocery cart, for example.
People with severe stenosis may have a habit of leaning forward in a stooped position to relieve pain.
Other symptoms may include:
Lumbar spinal stenosis usually starts gradually and gets worse over a long period of time. Narrowing of the spinal canal can squeeze and irritate the nerve roots that branch out from the spinal cord. This is what causes pain and other symptoms.
The course of spinal stenosis varies—it may stay the same, get better, or get worse.
Severe disability isn't common. But when symptoms are very bad, they can keep you from doing your normal daily activities. They can have a big effect your quality of life. If symptoms are still severe after you have tried other treatment for a while, surgery may be considered.
Surgery may be too risky for some older adults who have other serious health problems.
What Increases Your Risk
The risk of having lumbar spinal stenosis increases if you:
When To Call a Doctor
Call 911 or other emergency services immediately if a person has signs of damage to the spine after an injury (such as a car accident, fall, or direct blow to the spine). Signs may include severe back pain, or weakness, tingling, or numbness in one or both legs.
Call your doctor now or seek immediate medical care if:
Lumbar spinal stenosis usually gets worse gradually over months to years. If you have symptoms that come on suddenly, you may have another serious condition and should call your doctor.
If you begin to regularly have leg pain when walking and standing, call your doctor.
Who to see
The following health professionals can diagnose and treat spinal stenosis:
Specialists who can treat spinal stenosis include the following:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
Lumbar spinal stenosis can usually be diagnosed based on your history of symptoms, a physical exam, and imaging tests—tests that produce various kinds of pictures of your body. These tests include:
Your doctor may try nonsurgical treatment, such as pain-relieving medicines, exercise, and physical therapy, for a period of time before ordering imaging tests. If treatment works, you may not need tests.
Imaging tests can help confirm a diagnosis or rule out other problems. But even if imaging shows spinal stenosis, your symptoms may not match the results of the tests. So treatment is based on what your symptoms are and how much spinal stenosis is impacting your life, not just on the results of imaging tests.
The goals of treatment for spinal stenosis are to relieve pain, numbness, and weakness in the legs, to make it easier for you to move around, and to improve your quality of life.
You can't always prevent changes in your back that may come with aging. But you may be able to limit spinal stenosis symptoms by keeping your back as healthy as possible:
You can take steps to treat lumbar spinal stenosis symptoms at home:
Be sure to talk with your doctor before you start home treatment.
Pain and numbness in your legs can increase your risk of losing your balance. Falling can make symptoms worse. Take steps to lower your risk of falling:
Taking medicine along with other nonsurgical treatment is often enough to relieve pain and allow you to do normal daily activities.
Medicines used to relieve the symptoms of spinal stenosis include:
Surgery is done to relieve pressure on the nerve roots . This can help reduce pain, numbness, and weakness in your legs.
Surgery may be recommended if:
The goal of surgery is to relieve pain, numbness, or weakness in the legs—not to relieve back pain. People who have surgery only for back pain are less satisfied with the results than are those who have surgery for nerve root symptoms and pain in both the back and legs. Also, numbness, weakness, and pain may return after surgery.
Physical therapy is an important treatment for spinal stenosis. It can help with pain and build muscle strength.
Your physical therapist may teach you exercises to strengthen your abdominal (belly) muscles, which will help support your spine. You may also learn exercises to help maintain flexibility and reduce inflammation .
Alternative and complementary medicine therapies, such as acupuncture , are used by some people to relieve pain from spinal stenosis.
Other Places To Get Help
Last Revised: February 13, 2012
Author: Healthwise Staff
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