Topic Overview

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This topic is about spinal stenosis of the lower back, also known as the lumbar area. If you need information on spinal stenosis of the neck, see the topic Cervical Spinal Stenosis.

What is lumbar spinal stenosis?

Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back, known as the lumbar area. This narrowing occurs when the growth of bone or tissue or both reduces the size of the openings in the spinal bones. This narrowing can squeeze and irritate the nerves that branch out from the spinal cord. It can also squeeze and irritate the spinal cord itself. This may cause pain, numbness, or weakness, most often in the legs, feet, and buttocks.

What causes lumbar spinal stenosis?

Lumbar spinal stenosis is most often caused by changes in the shape and size of the spinal canal as people age. For example:

• Connective tissues called ligaments get thicker.
• Joint disease called osteoarthritis leads to the growth of bony spurs that push on the spinal cord.
• Discs between the bones may be pushed backward into the spinal canal.

These conditions can lead to problems that narrow the space in the spinal canal.

What are the symptoms?

If the spinal cord or nerves become squeezed, symptoms may include:

• Numbness, weakness, cramping, or pain in the legs, feet, or buttocks. These symptoms get worse when you walk, stand straight, or lean backward. The pain gets better when you sit down or lean forward.
• Stiffness in the legs and thighs.
• Low back pain.
• In severe cases, loss of bladder and bowel control.

Symptoms may be severe at times and less severe at other times. Most people will not be severely disabled. In fact, many people do not have symptoms at all.

How is lumbar spinal stenosis diagnosed?

Your doctor can tell if you have lumbar spinal stenosis by asking questions about your symptoms and past health and by doing a physical exam. You will probably need imaging tests such as an MRI, a CT scan, and sometimes X-rays.

How is it treated?

You can most likely control mild to moderate symptoms with pain medicines, exercise, and physical therapy. Your doctor may also give you a spinal shot of corticosteroids, a medicine that reduces inflammation.

You may need surgery if your symptoms get worse or if they limit what you can do. In these cases, surgery to remove bone and tissue that are squeezing the spinal cord can help relieve leg pain and allow you to get back to normal activity. But it may not help back pain as much.

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