Lumbar spinal stenosis

1) Understanding Lumbar Spinal Stenosis

 

 

The lumbar region of the spine is made up of 5 vertebrae. Between these vertebrae, there are intervertebral discs at the front, acting as shock absorbers, and joints at the back, allowing movements at each level in flexion, extension, and rotation.

In the center, the spinal cord passes through the lumbar canal, giving off nerve roots on each side, at each level, which exit between the vertebrae.

 

With aging, cartilage becomes thinner and the discs gradually collapse. Joint degeneration also leads to bone and ligament thickening, especially of the ligamentum flavum, which closes the canal from the back.

All these changes can progressively reduce the space within the canal, causing compression of the nerve structures. This can then lead to pain and sensory and/or motor disturbances in the back and/or lower limbs.

 

2) Lumbar spinal stenosis or narrow lumbar canal?

 

This condition is degenerative. That means it usually appears in older individuals, often after the age of 50.

It is therefore different from the so-called “narrow” lumbar canal of congenital origin, which is diagnosed and symptomatic in younger individuals. In older people, we rather talk about a “reduced” lumbar canal.

 

In practice, lumbar spinal stenosis diagnosed in adults often results from a combination of both: a congenitally narrow canal aggravated by age-related degeneration.

 

3) What are the symptoms of Lumbar Spinal Stenosis?

 

Lumbar spinal stenosis usually presents with:

• Back and/or leg pain, most often during walking or prolonged standing
• Reduced or lost sensation in one or both legs
• Motor problems or even paralysis in the lower limbs
• Urogenital problems

 

Note that symptoms including the last two points represent a surgical emergency.

 

4) How is Lumbar Spinal Stenosis diagnosed?

 

Diagnosis is based on patient history, clinical examination by a healthcare professional, and medical imaging.

While X-rays can sometimes be limited, CT scans or MRI are usually more revealing. An EMG may be ordered to confirm neurological deficits.

 

5) Is it serious?

 

It depends on the stage of the condition. In early phases, lumbar stenosis may be asymptomatic.
However, without treatment, symptoms usually worsen over time, potentially leading to severe problems and loss of autonomy.
Neurological complications are rarer but do exist and must be treated surgically as soon as possible.

If you have symptoms similar to those described above, it is important to consult a doctor to assess the severity and choose the appropriate treatment.

 

6) Is surgery necessary?

 

Lumbar stenosis generally responds well to medical and physical therapy.

Surgery is not considered as a first-line treatment. It is proposed only if symptoms do not improve significantly with conservative treatments or if pain becomes intolerable and cannot be relieved with medication.

 

It becomes essential if you develop nerve damage, such as weakness or loss of sensation in your legs, or urogenital problems.

 

7) How does rehabilitation work?

 

Initial treatment combines medical support (painkillers, anti-inflammatories) with rest and physiotherapy. Physiotherapy focuses on:

• Restoring joint mobility
• Progressive global and specific muscle strengthening
• Improving motor control
• Educating the patient about the condition and its potential risks

 

If surgery is required, physiotherapy starts a few weeks after, with return to physical activity considered a few months post-surgery.

 

8) What can I do to speed up recovery? What should I avoid?

 

To speed up healing, carefully follow the recommendations of the healthcare professionals you are working with.

 

Laziness or, on the contrary, overdoing it, will be your enemies.

 

On the other hand, discipline, perseverance, and a positive mindset will help you get back in shape as quickly as possible!

 

 

We care, you perform.