Lumbar Stenosis
Lumbar spinal stenosis describes narrowing of the central spinal canal, lateral recess, neural foramina or any combination of the three. Neural encroachment by the surrounding bone and soft tissue can induce subsequent "neurogenic claudication" or radiculopathy with resulting leg pain, numbness, paresthesia, weakness and difficulty Walking. Generally, the leg pain is made worse with any distance of walking and made better by rest or sitting.
Spinal stenosis can be classified as primary- caused by congenital/ developmental abnormalities, or secondary/acquired- arising from degenerative changes, trauma, infection or surgery. The most common form of stenosis is degenerative changes. This secondary form of spinal stenosis rarely occurs before the age of 50 and is more prevalent in the 6th and 7th decade of life. If you have primary stenosis from a congenital abnormality it would present far earlier in life.
Spinal stenosis is the number one cause of spinal surgery in a patients over the age of 65. However, studies have shown that conservative care and exercise rehabilitation prove to be better. In 2020, the World Federation of Neurosurgical Societies Spine Committee published the following expert consensus on lumbar stenosis management: "A conservative approach based on therapeutic exercise may be the first choice in patients with LSS except in the presence of significant neurologic deficits." (1) Other clinical practice guidelines concur. (2)
At this office we combine the best of both. We are trained in Cox Flexion Distraction which is a gentle, effective, decompressive technique for the lumbar spine. (3) We also know the exercises to do that will not hinder your condition, but instead help you to a pain free lifestyle.
Fornari M, Robertson SC, Pereira P, Zileli M, Anania CD, Ferreira A, Ferrari S, Gatti R, Costa F. Conservative Treatment and Percutaneous Pain Relief Techniques in Patients with Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations. World Neurosurgery: X. 2020 Jul 1;7:100079
Bussières A, Cancelliere C, Ammendolia C, Comer CM, Al Zoubi F, Châtillon CE, Chernish G, Cox JM, Gliedt JA, Haskett D, Jensen RK. Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical practice guideline. The Journal of Pain. 2021 Apr 12
Cox JM. Low back pain: mechanism, diagnosis and treatment. Lippincott Williams & Wilkins; 2012 Jan 18
