Spinal Stenosis
Spinal stenosis is the compression of spinal nerves caused by narrowing of spinal canal and it is one cause of leg pain (sciatica).
Spinal stenosis can usually be treated with conservative treatment approaches such as use of pain medications, physical therapy, steroid injections, or acupuncture. In chronic cases, surgery may be required to treat the condition.
The symptoms include burning or aching type of pain in buttocks that radiates to the legs (sciatica), weakness in the legs or “foot drop”.
The most common cause of spinal stenosis is ageing and wear in the spine. As age advances, osteoarthritis, disc degeneration and thickening of ligaments may develop and these conditions contribute to spinal stenosis. The other causes include Paget’s disease, achondroplasia, spinal tumours and spinal injuries.
Diagnosis requires a careful detailed history, clinical examination and investigations such as radiographs and an MRI scan.
Nonsurgical Treatment
- Physical therapy: Physical Therapy involves stretching exercises, massage, and lumbar and abdominal strengthening
- Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs) initially provide pain relief and also reduce swelling. Simple analgesics such as Paracetamol provide a safe alternative
- Steroid injections: Cortisone steroid injections are given around the nerves or in the “epidural space” to decrease swelling and pain
- Acupuncture: Acupuncture can be helpful in cases where the pain is less severe
Surgical Treatment
Surgery is considered for patients in whom the pain and weakness is causing debilitation such as inability to walk for a long time. The two main surgical procedures to treat lumbar spinal stenosis are laminectomy and spinal fusion.
- Decompressive Laminectomy: This procedure involves removal of the bone, bone spurs, and ligaments that compress the nerves
- Spinal fusion: In this procedure, two or more vertebrae are permanently fused together
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