Patient information
Lumbar spinal stenosis
Pain, heaviness or tingling in your legs when you stand or walk can limit how far you feel able to go. Lumbar spinal stenosis is one possible cause. Assessment helps distinguish it from other problems and identify what may improve your function.
What does spinal stenosis mean?
Lumbar spinal stenosis means narrowing of the spaces around the nerves in the lower back. Changes in the discs, joints and ligaments can reduce the room available for these nerves.
Symptoms may include aching, numbness or weakness in the buttocks and legs. They often become worse with standing or walking and ease with sitting or leaning forward. Some people also have back pain.
What happens during assessment?
It helps to describe how far you can walk, what brings on symptoms and what relieves them. Dr Baecker reviews your medical history and previous investigations and may examine your strength, sensation and movement.
An MRI can show the space around the nerves. X-rays or other tests may be considered depending on the findings. The assessment brings together the scan, examination and the effect on your life.
Choosing a treatment approach
Non-surgical care can help manage symptoms even though it does not reverse the narrowing. Options may include appropriate exercise, physiotherapy, changes to activities and a review of pain relief.
Decompression surgery may be considered when symptoms continue to substantially restrict daily life despite non-surgical care, or when nerve function is a concern. It creates more room for affected nerves. Fusion is considered in some circumstances, such as spinal instability; it is not required for everyone with stenosis.
Potential risks include infection, bleeding, a leak of spinal fluid, nerve injury and symptoms that persist or return. The likely benefits, individual risks and recovery need to be discussed before deciding on treatment.
When to seek urgent help
New difficulty passing urine, loss of bladder or bowel control, numbness around the genitals or bottom, or rapidly worsening leg weakness needs urgent medical assessment. Go to an emergency department; call 111 if you need emergency assistance. Do not wait for a reply to an online consultation request.
Questions to discuss
- What is most likely to be limiting my walking?
- Which non-surgical options are appropriate for me?
- If surgery is an option, what is it expected to improve and why?
Arrange a consultation
Dr Baecker consults at Domain Orthopaedic Surgeons in Parnell, Auckland. Self-referrals are welcome.