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Lumbar Stenosis

What is Lumbar Stenosis?

Lumbar stenosis describes the narrowing of spaces within the spinal canal in the lower back. The spinal canal is made up of bones called vertebrae, which protect the spinal cord. The lumbar spine consists of five vertebrae between the ribs and the pelvis. When the spinal canal narrows, it can put pressure on the spinal cord. This may cause pain and other symptoms.

Spinal stenosis is usually caused by wear-and-tear and other changes in the spine that can occur with age. Intervertebral discs, which provide a cushion between the vertebrae and enable movement in the spine, become less spongy with age. This can lead the bulging of hardened discs into the spinal canal (herniated discs), bone overgrowth (bone spurs), and thickening of ligaments—all of which can contribute to narrowing within the spinal canal.

Lumbar Stenosis Symptoms

Symptoms of lumbar stenosis usually appear gradually and may worsen over time. Some people may not notice any symptoms at all. Symptoms can include:

  • Aching or burning feeling starting in the buttocks and radiating down into one leg or both legs (sciatic nerve pain)
  • Bowel and bladder dysfunction (in severe cases)
  • Cramping in calves while walking
  • Difficulty walking
  • Lower back pain
  • Pain in the back or legs that worsens with walking/standing and improves with bending forward or sitting
  • Weakness or numbness in the legs, feet, and/or buttocks
  • Weakness in the foot that causes the foot to slap down when walking, known as “foot drop”

Other conditions share symptoms with lumbar stenosis. If you are experiencing any symptoms, please contact a medical professional. If you are experiencing a medical emergency, call 911.

Lumbar Stenosis Treatments

Surgical treatment is the only way to correct the narrowing of the spinal canal, but conservative treatments may help relieve pain and other symptoms. These include:

  • Anti-inflammatory medications to reduce swelling around nerves and relieve pain
  • Epidural steroid injections to reduce swelling and relieve pain
  • Physical therapy to stabilize the spine and increase strength and flexibility

You may be a candidate for surgery if you have the following symptoms and they are not responding to conservative treatments:

  • Difficulty standing or walking
  • Loss of bowel and bladder functions
  • Pain or weakness that impairs quality of life

Your doctor will also consider your overall health before recommending surgery.

The most common surgical procedure for spinal stenosis is decompressive laminectomy, in which the roof at least one vertebra is removed to create more space for the affected nerves.

Spinal fusion surgery, which involves uniting two or more vertebrae, may be recommended in some cases to stabilize the spine. These procedures can be done with minimally invasive spine surgery.

Additional Information

How common is lumbar stenosis?

Spinal stenosis is common. An estimated 250,000 to 500,000 Americans have symptoms of spinal stenosis. The lumbar spine is the most common location for spinal stenosis to occur.

Who gets lumbar stenosis?

Because lumbar stenosis is most often caused by degenerative changes in the spine, it usually affects people over the age of 50. However, younger people may be at risk if they have any of the following conditions:

  • Paget’s disease
  • Rheumatoid arthritis
  • Spinal deformity, such as scoliosis or being born with a narrow spinal canal
  • Spinal injury
  • Spinal tumor

How is lumbar stenosis diagnosed?

In addition to reviewing your medical history and performing a physical examination, your doctor may order one or more of the following imaging tests to diagnose lumbar stenosis:

  • Computed tomography (CT)
  • Electromyography (EMG)
  • Magnetic resonance imaging (MRI)
  • Myelogram
  • X-ray

Additional Resources

Medically Reviewed by Laura A. Snyder, MD, FAANS on January 24, 2021