Navigating Daily Life with Lumbar Stenosis

Lumbar stenosis affects people in different ways, with some people experiencing no symptoms whatsoever, while others may live with chronic, persistent pain. This can have a significant impact on a person’s daily life, affecting their career, relationships, and overall health, both physical and mental. 

We’ll discuss how a person with lumbar stenosis can navigate daily life with medical treatments, self-administered treatments, and changes to daily habits. We’ll also discuss surgical options should treatments prove ineffective, including spinal decompression, fusion, and mechanical spinal devices like the TOPS System.

Lumbar Stenosis: Explained

Lumbar stenosis refers to the narrowing of the spinal canal, which applies pressure to the many nerves that run down the length of the spine. The lumbar region is the lower part of the spine, but this condition can occur in any section of the spine. The most common cause of lumbar stenosis is the deterioration of the spine, a natural result of aging. However, it can also be caused by spinal conditions like spondylolisthesis, spinal injuries, bone diseases, spinal tumors, and may even be a genetic issue, with some people born with narrowed spinal canals. 

Lumbar Stenosis Symptoms

Symptoms of lumbar stenosis may come and go and vary in severity, with the symptoms worsening with walking or standing and improving with sitting or bending forward. Common symptoms include:

• Leg pain and cramping – Often described as aching, burning, or cramping pain that radiates from the lower back down into the buttocks and legs, typically worsening with walking or standing.
  
• Difficulty walking – Pain and weakness in the legs that develop after walking short distances and improve when sitting down or leaning forward (like on a shopping cart).
  
• Numbness and tingling – Sensations of pins and needles or numbness in the legs, feet, or buttocks, which may come and go or be constant.
  
• Weakness in the legs – Difficulty with leg strength that can affect walking, climbing stairs, or maintaining balance, potentially leading to stumbling or falls.
  
• Back pain – Lower back discomfort that may be present at rest but often worsens with certain positions or activities like walking or standing upright.
  
• Relief with flexion – Symptoms typically improve when bending forward, sitting down, or leaning on something, as these positions open up the spinal canal and reduce pressure on the nerves.

Treatments for Lumbar Stenosis

There are a number of non-surgical treatments that a doctor may recommend, including physical therapy and medications. Physical therapy focuses on strengthening core muscles, improving flexibility, and teaching proper body mechanics. 

Meanwhile, anti-inflammatory medications like NSAIDs help reduce pain and swelling, while other pain medications may be prescribed for symptom management. Epidural steroid injections can provide temporary relief by reducing inflammation around compressed nerves. Activity modification involves avoiding positions that worsen symptoms while maintaining appropriate exercise levels.

Surgery is typically considered when conservative measures fail to provide adequate relief, symptoms significantly impact quality of life, or there are signs of progressive neurological problems. The choice of treatment depends on symptom severity, overall health, activity level, and patient preferences.

A laminectomy is the most common procedure, involving the removal of part of the vertebral bone (lamina) to create more space for the spinal cord and nerves. Laminotomy is a less invasive version that removes only a small portion of the lamina. Foraminotomy enlarges the openings where nerve roots exit the spine. In cases with spinal instability, fusion surgery may be combined with decompression procedures to stabilize the spine.

Newer techniques include endoscopic procedures and minimally invasive decompression surgeries that use smaller incisions and specialized instruments to achieve similar results with potentially faster recovery times.

Lumbar Stenosis: Surgical Considerations

Surgery always carries an element of risk, and procedures such as laminectomies and spinal fusion come with potential long-term side effects. Risks include infection, prolonged bleeding, blood clots, spinal cord injuries, pain, bowel and bladder problems, and spinal fluid leakage. 

Spinal fusion can permanently reduce a person’s mobility and range of motion, as the fused vertebrae make it impossible to perform some basic movements such as twisting and bending. This is why many doctors now recommend modern spinal devices, like the TOPS system, which imitate the natural flexibility of the spine so there is no impact on mobility. 

Lifestyle Changes to Better Navigate Lumbar Stenosis

Maintaining a better posture and focusing on the position of the spine while performing daily tasks is important for anyone with lumbar stenosis. For example, a person should use a shopping cart when grocery shopping or walk with a cane to maintain a slightly forward-leaning position. This opens the spinal canal and reduces symptoms. Sitting more frequently during activities is also recommended, and choosing chairs with good back support.

It’s important to maintain a healthy weight to reduce pressure on the spine and improve overall mobility. This can be done with a healthy diet and regular exercise. Individuals should focus on low-impact activities like swimming, stationary cycling, or walking on a treadmill with an incline (leaning forward). Performing gentle stretching exercises, particularly hip flexor stretches and knee-to-chest stretches, is recommended. A person can also strengthen their core muscles with simple exercises like pelvic tilts.

Avoid prolonged standing or walking on flat surfaces. When standing for extended periods, place one foot on a small stool and alternate. There are also ergonomic tools like long-handled reachers to avoid excessive bending. Sleeping in a fetal position or with knees elevated using pillows can be beneficial.

There are several self-treatment methods a person could consider, such as applying heat before activities to loosen muscles and cold packs after activities to reduce inflammation. These modifications can significantly improve daily functioning and reduce pain without requiring medical intervention.

Thank you for reading. We hope this article has provided some helpful suggestions to make dealing with lumbar stenosis easier.