Lumbar spinal stenosis is one of the most common causes of back and leg pain in older adults here in the United States.
It mainly affects millions of people over the age of 50, but with our aging population, you can bet that number will grow considerably.
The diagnosis of spinal stenosis can be made by a radiologist and confirmed by a physician and physical therapist team.
Treatment for spinal stenosis differs appreciably from other low back disorders, so accurate diagnosis is essential when trying to identify the proper course of management.
So, if you've been wondering why your back and legs have been hurting, or if this diagnosis has been suggested to you in the past, see if any of the following scenarios fits your back:
If you walk bent over, get checked out. Spinal stenosis forces the spine into a flexed or "bent forward" position. The most common example is called the 'grocery cart' sign. People who normally have trouble walking can walk much further than usual when leaning on a grocery cart.
If your back gets heavy and feels like it could give out. Stenosis causes a pinching of sensitive nerves in your back. These nerves control everything from sensation to the vital motor function of your legs. If the pressure from the stenosis significantly compromises the nerves, a feeling of heaviness, or in some cases pain, will force you to change positions or even sit down.
If sitting down is preferable to standing up, stenosis could be the reason why. Most forms of mechanical low back pain are eased with some movement and upright postures but not stenosis. Other pathologies such as disc bulges and herniations are exacerbated by sitting — making the "sitting sign" a hallmark feature of spinal stenosis.
If the reflexes in your ankles and knees are absent, it's likely that you have nerve compression in your back. Under compression, nerves are unable to accurately transmit signals, and the reflex arc is usually one of the first things to go.
Aching in the legs can be caused by stenosis. Pinching any of the nerves in your back will alter the sensation and cause strength loss in your legs. You may feel like your knees want to give way or that it's hard to pick up your feet when you walk.
If your doctor has told you in the past that you have significant arthritis, it may have progressed to stenosis. The words "spinal stenosis" refer to a closing or narrowing of the passageways through which nerves travel. If you're experiencing any other signs and you know you have "bad arthritis" it wouldn't hurt to be examined by a spine clinician.
If straightening your back makes your legs go to sleep you most likely have spinal stenosis.
Extension of the lumbar spine further compresses the holes where the nerves exit the spinal cord. During back extension (straightening), these holes are closed and in some cases, shut. Don't go too long without an examination if you reach thus point.
Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes "On the Mend" weekly. Questions may be submitted to Joe by e-mail joedivincenzo@comcast.net.
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