Lumbar Spinal Stenosis: Causes and Diagnosis
Back pain is one of the most common reasons Americans visit a doctor. While back pain can occur due any number of issues, lumbar spinal stenosis is frequently a cause in those age 60 and older.
Because untreated spinal stenosis can worsen over time, prompt diagnosis is important. Imaging scans performed at Touchstone Medical Imaging help your doctor provide a definitive diagnosis and formulate a treatment plan.
Defining Lumbar Spinal Stenosis
If you’re experiencing low back pain, particularly if you also feel leg pain, lumbar spinal stenosis could be the cause. Stenosis affecting the lumbar spine is typically a degenerative condition. That means that the damage occurs over years and even decades, primarily as a result of wear and tear on the spinal cord. Over the years, the spinal canal narrows, which squeezes the nerves located in the spine and down the legs.
When this happens, you may experience a variety of symptoms, including:
- Back pain
- Foot drop, or difficulty lifting the front part of the foot
- Leg weakness
- Neck pain
- Numbness or tingling in the arms or hands
- Numbness or tingling in the buttocks or legs
- Sciatica (pain in the buttocks or leg pain)
- Upper extremity weakness
Because the discomfort caused by spinal stenosis is related to the spinal canal narrowing, pain may alleviate with certain positions of the body. Bending forward, sitting or lying down can provide temporary relief because the act of leaning forward opens up more space for the spinal nerves.
In rare instances, someone with lumbar spinal stenosis may also experience a condition known as acute cauda equina syndrome. This condition occurs when severe compression of the spinal nerves causes numbness in the groin. The person may lose bladder and bowel control. If these symptoms are present, seek emergency medical attention and treatment.
Causes of Lumbar Spinal Stenosis
In some cases, people are born with a small spinal canal, a condition known as congenital stenosis. But far more people develop lumbar spinal stenosis over time.
Age-related spinal changes occur in nearly everyone, affecting up to 95% of adults by the time they reach their 50th birthday. As we age, the discs in the spine lose water content, causing the discs to shorten. Sometimes, they bulge into the spinal canal as they dry up and harden. Bone spurs can pop up and ligaments can thicken as we get older. These bone spurs also may contribute to the narrowing of the spinal canal.
Osteoarthritis often causes age-related spinal changes and lumbar spinal stenosis. This type of arthritis stems from normal wear and tear on the joints, which occurs as we use them in daily activities over a period of time.
Rheumatoid arthritis, spinal tumors, ankylosing spondylitis and Paget’s disease also sometimes cause spinal stenosis.
How Lumbar Spinal Stenosis Is Diagnosed
If you’re experiencing back pain that radiates down into the buttocks and legs, your doctor may suspect spinal stenosis. To confirm a diagnosis, your doctor will perform a thorough physical examination, paying extra attention to painful areas of the body.
Because the discomfort of lumbar spinal stenosis typically worsens in some positions, your doctor will likely ask you to move through multiple positions. This will give your doctor a good idea of when pain intensifies and when it eases.
After a physical examination, imaging scans will help your doctor get a close-up look at the structures within your spine. Multiple types of imaging scans play a role in diagnosing lumbar spinal stenosis:
- CT scans weave X-rays together to capture cross-sectional images of the body. These images show the bony structures in the spine.
- A CT myelogram uses dye injected into the spine to highlight the spinal nerves and identify any compression.
- MRI takes detailed images of the soft tissues in the body. MRI helps doctors get a good look at the muscles, discs, spinal nerves and the spinal cord.
- X-rays take detailed photos of the bones. They help show age-related changes associated with spinal stenosis, such as shortened spinal discs.
These imaging scans, all performed by Touchstone Medical Imaging, will provide your doctor with a comprehensive look at your spine, helping to confirm whether you have spinal stenosis.
In some cases, your doctor may also order an electromyogram to evaluate the health of the nerves in your legs.
How Lumbar Spinal Stenosis Is Treated
While it can take years for lumbar spinal stenosis to develop, it’s important that the condition be effectively treated. Untreated spinal stenosis can worsen over time, contributing to intense pain, prolonged discomfort, an inability to perform normal activities, and a loss of bladder or bowel control. In the most severe cases, spinal stenosis leads to disability.
Treatment for lumbar spinal stenosis often begins with nonsurgical options, proceeding to surgery in severe cases or when other therapies do not provide relief. Nonsurgical treatments do not address the narrowing of the spinal canal. However, they may provide some relief and restore function.
Several nonsurgical treatment options can help with pain and mobility, including steroid injections, oral medication or physical therapy. Your doctor will recommend a treatment or combination of treatments based on your individual needs, including your overall health, the severity of the stenosis and the underlying causes of the condition.
In some cases, your doctor may suggest alternative or complementary therapies such as acupuncture or chiropractic manipulation alongside these more traditional treatment options.
If you have a severe case of lumbar spinal stenosis, your doctor may suggest surgical treatment. Surgery helps correct the underlying issue of the stenosis, helping restore quality of life.
Convenient Imaging for an Informed Diagnosis
Experiencing back pain that may be associated with lumbar spinal stenosis? Imaging scans can help confirm a diagnosis. Touchstone Medical Imaging has multiple locations in seven states, and same- and next-day appointment options are available, making your imaging scan as convenient as possible.
With your doctor’s referral, find the closest Touchstone Medical Imaging center and request your appointment today.