Lumbar spine stenosis is a condition where the space in the lower spinal canal narrows. The spinal canal houses the spinal cord along the back. Narrowing of this space causes pain, numbness to weakness in the legs in more serious cases. Therefore, in extreme cases, loss of bladder and bowel control. This condition typically affects adults over the age of 50.
Compression of the spinal cord
The pain symptoms result from the spinal cord being compressed by the narrowing spinal canal. Depending on the amount of pressure on the spinal cord, the symptoms vary. Beginning from mild pain when there is some compression to weakness in the leg when there is so much pressure that signals sent to the leg muscles are cut off. In some cases, compression of the nerves of the lumbar spinal cord can cause loss of bladder, bowel and sexual functions.
Hence, people with lumbar stenosis find a bent forward position while walking; sitting down or squatting helps relieve the pain. This position relieves some of the pressure by decompressing the compressed area. Generally, bending backwards on the other hand increases the pain.
Why does the spinal canal narrows?
In most case, the spinal canal narrows as a result of degenerative changes in the lower back vertebrae as we age. The degenerative process causes excessive bone growth (osteophytes), ligament enlargement (ligamenteous hypertrophy), or loss of spinal disc height. This is the main reason why lumbar stenosis most commonly seen in adults over the age of 50.
What are the treatment options?
In severe cases where there is a weakness in the lower limbs or loss of bladder and bowel functions, surgery is an option to immediately relieve the pressure off the nerves.
In milder cases or immediately post-surgery, rehabilitative physiotherapy treatment recommended to improve posture and strength of the muscles around the lower back and abdominal region. This helps reduce the amount of compression on the spinal cord in the lower back area.
Note that even after surgery, treatment and continued self-management through exercises is important as degeneration, the primary cause, continues. As we continue to age, we continue to get more excessive bone growth, our ligaments enlarge and our spinal disc continues to lose their height.
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