Overview

Lumbar Spinal Stenosis

Lumbar spinal stenosis happens when the spinal canal in the lower back becomes narrowed. This narrowing, also called stenosis of the spine, can compress the spinal nerves and cause symptoms throughout the lower body. The spinal cord and nerves travel through a protective canal formed by the vertebrae. When that space becomes tight due to aging, injury, or arthritis, the nerves become irritated and inflamed. This may lead to back pain, leg numbness, difficulty standing, or symptoms similar to sciatica.
Lumbar spinal stenosis is most often a degenerative condition and is especially common in people aged 60 and older.

What causes Lumbar Spinal Stenosis?

The most common cause of lumbar spinal stenosis is arthritis caused by wear and tear of the spine over time. As the joints and discs of the lumbar spine age, they may thicken, bulge, or form bone spurs, all of which reduce space in the spinal canal. This gradual degeneration creates pressure on the nerves and leads to symptoms.

Several other conditions can also narrow the spinal canal, such as:

• • Bone spurs that grow and crowd the spinal canal
  • Infections of the spine that irritate or inflame spinal tissues
  • Herniated discs, which push into the canal
  • Injury or trauma that shifts vertebrae or damages ligaments

• Thickening of spinal ligaments, which takes up space in the canal

How the Condition Develops: The narrowing of the spinal canal usually progresses slowly as the lower spine changes with age. Discs lose height, joints become larger, and bone spurs may appear. These changes reduce the space around the nerves and lead to irritation and inflammation. Symptoms often become more noticeable when standing or walking because the canal tightens in those positions.

Common Everyday Causes: Everyday habits can add to the strain. Long periods of standing, walking uphill, or carrying heavy loads place extra pressure on the lower back. Poor posture, weak core muscles, and older back injuries can make the narrowing more troublesome. People who naturally have smaller spinal canals tend to develop symptoms sooner.

Lumbar Spinal Stenosis Is Common in Older People Who Play These Sports

• Baseball & Softball: Repetitive twisting and bending place stress on the lumbar spine.
• Basketball: Jumping and landing can compress the lower back.
• Dancing: Repeated back extensions and rotations contribute to spinal wear.
• Football & Hockey: High-impact collisions increase the risk of injury to spinal structures.
• Gymnastics: Extreme back bending and high-impact landings can cause early degeneration.
  
• Soccer: Quick movements and sudden direction changes strain the lumbar spine.

Symptoms

Lumbar spinal stenosis can cause a range of symptoms depending on how much pressure is placed on the nerves. Common symptoms include:

• Lower back stiffness and soreness
• Pain that improves when leaning forward, sitting, or bending
• Sciatica-like pain radiating down one or both legs
• Claudication pain, which worsens with walking or standing and improves with rest
• Muscle cramping in the back or legs

As the narrowing becomes more severe, symptoms may include:

• Numbness or tingling in the legs or feet
• Weakness in the legs
• Loss of bowel or bladder control (a medical emergency)

Symptoms usually progress slowly and may worsen over months or years.

Non-operative treatment

Most people with lumbar spinal stenosis experience symptom relief with conservative back pain treatment, such as:

• Avoiding high-impact activities, like running or heavy lifting
• NSAIDs (ibuprofen, naproxen) to reduce pain and inflammation
• Physical therapy to improve posture, mobility, core strength, and balance
• Daily home exercise programs to maintain spinal flexibility and stability
• Chiropractic care, which some individuals find helpful
• Steroid injections to decrease inflammation around the nerves
• Assistive devices, like a cane or walker, if walking becomes difficult
• Alternative therapies such as acupuncture

These treatments aim to reduce nerve irritation and improve overall function without surgery.

Below is a PDF of the Exercise Program: 

Lumbar Stenosis

Surgical Treatment

Surgery may be considered when conservative care no longer provides relief or when symptoms continue to progress. Common surgical options for lumbar spinal stenosis include:

Percutaneous Image-Guided Lumbar Decompression (PILD or MILD): A minimally invasive technique that removes a portion of a thickened ligament to create more space in the spinal canal. This procedure is only recommended for patients with ligament overgrowth.

Laminectomy: A surgeon removes part or all of the lamina, the protective bone covering the spinal canal, to relieve nerve pressure. Laminectomy may also include the removal of bone spurs or herniated discs.

Spinal Fusion: Often performed along with a laminectomy when the spine needs stabilization. The surgeon places a bone graft and metal hardware to permanently join two or more vertebrae. This prevents abnormal motion and reduces nerve compression.