Lumbar Stenosis (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Lumbar spinal stenosis facts
- What is the lumbar spine, and what is lumbar spinal stenosis?
- What causes lumbar spinal stenosis?
- What are the signs and symptoms of lumbar spinal stenosis?
- How is lumbar spinal stenosis diagnosed?
- What is the treatment for lumbar spinal stenosis?
- What can be done to prevent lumbar spinal stenosis?
- What is the outlook (prognosis) for lumbar spinal stenosis?
What causes lumbar spinal stenosis?
The most common cause of lumbar spinal stenosis is degenerative arthritis and degenerative disc disease. As with other joints in the body, arthritis commonly occurs in the spine as part of the normal aging process and as a result of osteoarthritis. 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, also known as spondylosis), and overgrowth (hypertrophy) of the ligamentous structures. Further degeneration of the lumbar discs can lead to slippage of one vertebra on another, a process referred to as spondylolesthesis. Each of these processes can reduce the normal space available for the nerves in the spinal canal and result in direct pressure on nerve tissues to cause the symptoms of 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 (abnormal tissue enlargement of structures that make up the spinal canal),
- various metabolic bone disorders that cause bone growth, such as Paget's disease of bone.
These causes, however, are much less common than degenerative arthritis.
What are the signs and symptoms of lumbar spinal stenosis?
Lumbar spinal stenosis can cause
In most situations, 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 backward can make the symptoms worse. This is because bending forward increases the space in the spinal canal and vertebral foramina, while bending backward decreases this space. It is therefore more comfortable for patients to sit or lean forward. Patients are frequently unable to walk for long distances and often state that their symptoms are improved when bending forward while walking with the support of a walker or shopping cart.
The symptoms commonly 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 that mimic lumbar spinal stenosis including
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