What is lumbar spine stenosis?
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Do you suffer from pain or aching, numbness, and heaviness in your legs when standing up or walking, which tends to ease again when you sit down? Mathew Guilfoyle, consultant neurosurgeon at Nuffield Health Cambridge Hospital, offers some advice.
Lumbar spine stenosis
Back and leg pain are very common symptoms that affect most people at some point in their life. Often these symptoms are mechanical, but in many people there is a condition that results in gradual pressure on the nerves to the legs causing discomfort and deterioration in mobility – lumbar spine stenosis. There are very effective treatments for this condition that can relieve pain and restore quality of life, so it is important to recognise it.
What is lumbar spine stenosis?
Lumbar spine stenosis (LSS) is narrowing of the spinal canal in the lower back due to accumulation of ‘wear and tear’ changes affecting the ligaments and joints between the bones of the spine. The narrowing causes compression and irritation of the nerves that supply the legs, and this generally gets slowly worse over the course of months and years.
How common is it?
LSS is very common, overall affecting around one in 10 of the general population. However, over the age of 60, as many as half of people will have some degree of LSS, though not always symptomatic.
What are the symptoms?
The characteristic symptoms are pain or aching, numbness, and heaviness in the legs that is brought on by standing up or walking, and tends to ease again when sitting down. There is often low back pain as well, but is unusual as the only symptom of LSS. The severity of leg pain can vary day-to-day but, generally, will get worse over time as the condition progresses. As a result, the walking distance that brings on the symptoms gradually gets shorter, and people have to stop and rest more frequently or find they need to keep their back flexed in a stooped position.
How is it diagnosed?
People with suspected LSS are usually first assessed by a doctor or specialist physiotherapist and an MRI scan is required to demonstrate the narrowing. Together with a pattern of pain in the legs described above this would support the diagnosis of symptomatic LSS. The management and treatment options would then be discussed.
What treatment is available?
Many people with milder LSS can manage their symptoms by keeping as mobile as possible and taking pain relief as required. There is the option of injections to the spine that can give relief of pain for several weeks. To address the narrowing itself there is the option of surgery to decompress the nerves. It is rare for symptoms of LSS to suddenly get worse, but if this happens can necessitate urgent surgery.
What does surgery involve?
Lumbar decompression is a very effective and safe operation to relieve the symptoms of LSS. For most people, the operation can be performed using minimally invasive (‘keyhole’) techniques through a small incision on the lower back. Most patients have rapid improvement in their leg pain and mobility, and can go home the same day or the day following their operation. Other than avoiding heavy lifting for a few weeks, patients can return to normal daily activities, including work and driving, as soon as they feel able to.
Mr Mathew Guilfoyle can be seen at Nuffield Health Cambridge Hospital, 4 Trumpington Road, Cambridge CB2 8AF. For more information call 01223 370922, email cambridge.enquiries@nuffieldhealth.com or or visit nuffieldhealth.com/hospitals/cambridge.
