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 risk factors for 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?
How is lumbar spinal stenosis diagnosed?
The medical evaluation begins with a complete medical history and physical examination to get clues to the diagnosis of lumbar spinal stenosis. During the medical history, the patient will be asked questions regarding symptoms, including how long they have been present, what makes them better or worse, what prior treatment the patient has had, and what other medical conditions they have. These questions can also help the doctor distinguish lumbar spinal stenosis from other disorders that may produce similar symptoms.
The physical examination often consists of testing the range of motion in the back and feeling for areas of tenderness in the back. The legs may be examined for range of motion, strength, sensation, reflexes, and pulses. The hips and knees may also be examined because problems with these joints can often causes symptoms similar to those of lumbar spinal stenosis.
After the examination, the physician may order imaging studies to detect anatomic signs of lumbar spinal stenosis. This often begins with plain X-rays of the spine. The doctors may also order an X-ray of the patient's pelvis and hips, depending on findings from the physical examination. The X-rays can show the doctor various signs associated with spinal stenosis, including loss of the normal intervertebral disc height, the presence of bone spurs (osteophytes), and spinal instability (abnormal motion between the vertebrae). The ultimate diagnosis of lumbar spinal stenosis is made by an MRI scan (magnetic resonance imagining scan) or CT scan (CAT scan or computerized axial tomography). These are more advanced tests that are used to visualize the nerves in the lower back and detect if they are being compressed from lumbar spinal stenosis.
In some cases, special nerve tests, including electromyogram (EMG) or nerve conduction studies, may be ordered. These tests can identify damage to or irritation of the nerves caused by long-term compression from lumbar spinal stenosis. These tests can also help determine exactly which nerves are involved.
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