Back on Your Feet

Spinal stenosis refers to a narrowing of the spinal canal that causes nerve roots or the spinal cord to become squeezed.

Spinal stenosis can occur in either the lower (lumbar) back or in the neck (cervical) area. Spinal stenosis affects the lower back more often than any other area.  Spinal stenosis of the neck occurs more rarely but can be crippling if not treated.

Many people over the age of 50 have some narrowing that does not cause any type of problem. However, if you experience any of these symptoms you should seek a doctor’s counsel:

• Lower back pain
  
  
• Stiffness in legs and/or thighs
  
  
• A numbness or weakness in your buttocks, legs or feet.
  
  
• Cramping or pain in your buttocks, legs or feet.
  
  
• Loss of bladder and bowel control

The classic symptom of lumbar spinal stenosis is leg pain when walking and standing. This pain usually disappears when you sit down. In spinal stenosis, leg pain is often present when the spine is extended, as in a standing position, and is relieved when the spine is flexed, as in a sitting position or when walking uphill or leaning over a grocery cart. Some people who suffer from spinal stenosis find bicycling more comfortable than standing or walking. People with severe cases may develop a habit of leaning forward in a stooped position to relieve symptoms.

Treatment is based not only on imaging test results, but also on the severity of symptoms and their impact on your normal daily activities and quality of life. You may have very severe symptoms, but tests may show relatively little narrowing of the spinal canal. Or you may have mild symptoms, but tests show a significant narrowing of the spinal canal.

Treatment includes a wide range of options

The goal of treatment is to relieve pain, numbness, and weakness in the legs and improve your ability to function and quality of life. Treatment includes pain-relieving medication, exercises, and other nonsurgical measures, and in some cases, surgical treatment.

Some forms of nonsurgical treatment can be done at home. These include:

• Medications to relieve pain. These include nonsteroidal anti-inflammatory drugs or acetaminophen.
  
  
• Physical therapy. Therapists can teach you which movements will help, such as proper lifting positions, and which will aggravate your symptoms, such as standing erect for lengths of time.
  
  
• Exercising. Aerobic exercise as well as stretching and strengthening exercises for the lower back and stomach muscles can relieve symptoms and improve muscle strength, especially when done 4 to 5 times a week. The most beneficial aerobic exercises are riding a stationary bicycle (with the spine flexed in a forward position), walking on a treadmill using a harness that relieves pressure on the lower back, or walking on a treadmill with an incline.
  
  
• Restricting activities that make your symptoms worse. Depending on the severity of your case, these might include walking and standing for a length of time.