I was diagnosed with spinal stenosis recently. This explains so much of the pain I experience everyday. The pain and inability to live a normal life at age 45 is pretty unbearable at this point. I’ve had 2 back surgeries and am looking at my third sometime within the next month or two. I hope this one enables me to walk and live like everyone else does.
Your Aging Back: Understanding Lumbar Spinal Stenosis
Do you experience dull, aching or burning pain in your lower back when you walk or stand? Does that pain radiate down into one or both of your thighs? Does that pain go away when you bend forward or lean on a shopping cart?
Perhaps, like many, you have dismissed your symptoms as the aches and pains of getting older, don’t make that mistake. You may be suffering from a common back problem that turns tens of thousands of older Americans into involuntary couch potatoes — that back problem is lumbar spinal Stenosis.
What is Lumbar Spinal Stenosis?
Lumbar spinal stenosis (LSS) is a degenerative condition of the spine that is generally characterized by pain in the lower back which radiates to the buttocks and down to the legs, often causing associated numbness, tingling and weakness when walking. Although rare, in its most advanced form, LSS can cause serious neurological problems, including significant leg weakness and difficulty with bowel and bladder function.
Lumbar spinal stenosis is a hidden epidemic and its pain will inevitably become more common as our lifespan continues to grow longer and Baby Boomers reach retirement age. The good news is that sufferers can usually be helped with available, proven treatment options.
Understanding the Condition
It is estimated that as many as 400,000 Americans, most of them over 60, may currently be experiencing symptoms of LSS – but may not yet have had the condition diagnosed. Many may simply have changed their lifestyles, giving up physical activities to manage their pain on the assumption that their condition is part of getting old.
Unfortunately, LSS can be difficult to diagnose because symptoms may be intermittent and are complicated by the presence of similar conditions commonly associated with aging. LSS occurs when the disks that separate and cushion our vertebrae dehydrate and shrink as we grow older. The bones and ligaments that make up our spine become less pliable and thicken. These changes cause a narrowing of the spinal canal which, in certain cases, causes compression of the nerves in the lumbar spine resulting in lower back pain, loss of sensation and possibly loss of function of the legs.
Sufferers generally find relief when they stop walking and sit down, encouraging many to become involuntary “coach potatoes.” Bending forward while walking also provides some relief; this is a common posture of those suffering from LSS.
It is not uncommon for those suffering from LSS to be diagnosed as having hardening of the arteries (vascular disease), arthritis, back strain or other common ailments associated with aging. Because of the nature of the condition, it does not show up on the X-rays often used to screen patients for conditions with similar symptoms such as fractured or slipped vertebrae or tumors involving the spine. Doctors rely on a combination of medical history, physical examination and either magnetic resonance imaging or a computed tomography scan to confirm a diagnosis of LSS.
Patients play an important role in identifying and getting proper treatment for this condition. If you suffer from back pain when you walk, and if that pain radiates from your lower back to your legs, and if you feel better when you sit down, tell your doctor and ask if a neurosurgical consult is in order.
Treatment Options
Treatment options vary according to the severity of the condition. Ibuprofen (Advil), aspirin, acetaminophen (Tylenol) and naproxen sodium (Aleve) are often used in the early stages to manage pain. Some patients may get relief with physical therapy and cortisone injections (epidural steroids)around the spinal sac. For more advanced cases, surgery is often the treatment of choice. The most common procedure, known as a decompressive laminectomy, is performed about 60,000 times annually on patients over the age of 60, with improvement reported in 75-80 percent of patients.
The surgery involves removing the lamina — the posterior portion of the vertebra —and attached ligaments surrounding the spinal canal and, if necessary, widening the canals through which nerve roots travel. Patients typically are out of the hospital within two to five days, able to walk almost immediately and are totally recovered within six weeks to six months.
© Copyright 2000 American Association of Neurological Surgeons
Source: Your Aging Back: Understanding Lumbar Spinal Stenosis
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