Dr. MJ Bazos MD,
Lumbar Spinal Canal
Stenosis: A Common Cause of Back and Leg Pain
What is lumbar spinal canal
Lumbar spinal canal stenosis is a narrowing in
the space in the lower spine that carries nerves to your legs. This space is
very small. It gets even smaller if the bone and tissue around it grow. It takes
many years for this bone and tissue to grow.
Arthritis, falls, accidents and wear and tear on
the bones and joints in the spine also play a part in stenosis. As the lumbar
spinal canal shrinks, the nerves that go through it are squeezed. This squeezing
may cause back pain, leg pain and leg weakness. Many adults have this kind of
How does my doctor know I have
stenosis in my spine?
Your doctor will ask you questions about your
symptoms. People with stenosis usually have back pain most of the time. They
also may have leg pain, numbness or weakness. The leg pain and numbness usually
start when you stand up and begin to walk or exercise. The leg pain has been
described as a burning or prickly feeling that may start in the buttocks and
spread down to the feet when you start walking.
Your legs might also feel cramped, tired or
weak. These leg symptoms are a condition called neural claudication of the legs.
If you have lumbar canal stenosis, the neural leg claudication starts when you
stand up, gets worse when you walk and gets better when you stop walking. Often,
the leg pain gets better if you crouch down or lie down in a fetal position (on
your sides with your knees tucked up to your chest). It's believed that these
positions "open" the lumbar canal and take the pressure off the nerves that go
to the legs.
Leg claudication starts slowly but gets worse
after a while. The leg pain begins slowly and gets worse with activity.
Although your doctor can probably tell if you
have claudication just by asking you certain questions, sometimes special tests
and x-rays of the spine are needed.
Is this the same thing as a ruptured
Lumbar canal stenosis is not the same thing as a
ruptured disk. A ruptured (or herniated) disk usually pinches 1 or 2 nerves at a
time. The pain caused by a pinched nerve in the lumbar spine is usually easy to
diagnose. This pain has a special name: sciatica. Sciatica usually causes back
pain that shoots down one leg. This pain can happen any time, not just when you
stand up or start walking.
What can I do for the pain and
Once you know you have lumbar canal stenosis or
claudication, you have several choices for treatment, depending on how bad your
symptoms are. If your pain is mild and you haven't had it for very long, you can
try an exercise program or a physical therapy program, to strengthen your back
muscles and improve your posture. Your doctor may also prescribe medicine for
inflammation (soreness and swelling) in your spine.
If you have severe back pain and claudication,
however, you may need to see a spine surgeon. This doctor may recommend surgery
to take the pressure off the nerves in your lower spine. The surgery is called a
laminectomy (say: lam-in-ek-toe-me), since parts of your spine called the lamina
are taken out to make room for the nerves in the spinal canal. This surgery
works well for many people.