Sciatica Pain Lumbar spinal stenosis

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Is Lumbar Spinal Stenosis to Blame for Your Sciatica?

Spinal stenosis in your lower back (lumbar) can cause the intense, radiating pain that is typical of sciatica. Stenosis is a narrowing of the spinal canal, or openings along the lower spine. This narrowing can impinge on your sciatic nerves located along your vertebral column. This form of nerve compression generates an extremely sharp pain that radiates to your buttocks, thighs and through your calf muscles.

Understanding Lumbar Stenosis as a Cause of Sciatica

The best way to visualize how lumbar stenosis can cause sciatica is to imagine that your sciatic nerve is like a telephone wire that carries information to and from your legs to your spine. When these electric impulses move along the wire without being impeded, all is well. The signal is clear. But if one of your lumbar vertebrae is herniated, or if your spinal canal has narrowed, the wire is compressed or pinched, sending a faulty signal of pain that comes from your buttocks, thighs and calf muscles on one or the other side of your body.

Some people may actually hardly feel any back pain at all. All the pain is radiating from their thighs or legs. This is technically a form of phantom pain. There is nothing physically wrong with the legs, which is very hard for patients to believe because the pain is so excruciating.

Spinal stenosis can also cause posture and gait problems as individuals attempt to reduce pain by standing and walking differently. There are also cases where the patient may have unexpected bowel or urination issues.

To diagnose spinal stenosis as a cause of sciatica, your back surgeon will require a complete medical history, a physical exam to test leg reflexes, range of motion and peripheral pulses. Typical diagnostic tests can include spinal X-rays, magnetic resonance imaging (MRI) and possibly a computerized tomography (CT) scan. Your doctor is looking for changes in your spine. As we age and the spine undergoes constant repetitive stressors, problems may develop between the vertebrae, discs can herniate and the spinal column can narrow. Once your diagnostic tests are completed, your back doctor will be able identify a cause such as spinal stenosis, or combination of causes that are responsible for generating your sciatica pain.

It is important to understand that spinal stenosis is a condition of the spinal canal. Many people think that the spinal cord runs through the vertebrae. Actually the spinal cord runs through the spinal canal from the neck to sacrum, which is just below the lumbar region of the back. The front wall of the spinal canal is composed of the back portions of the vertebrae which protect the front surface of the spinal cord. The sides of the spinal cord are protected by the pedicles of the spinal column. The rear of the spinal cord is protected by very sturdy and flexible bones called lamina which overlap almost like armor. This skeletal cage that serves as the spinal canal provides humans with tremendous flexibility, and at the same time a great deal of protection for the spinal cord.

There are non-surgical treatments for sciatica caused by lumbar stenosis such as aspirin, NSAIDS, narcotic pain killers and steroid injections. There are also physical therapy, braces, traction, manipulation therapy and even yoga that may help reduce the pain. Your back doctor will work closely to develop the optimal pain relief strategy. If the preliminary therapies do not work, then surgical treatment will need to be considered. We offer a wide range of minimally invasive surgical options in an outpatient environment that will get you home on the same day as your treatment.

Tips for Preventing and Managing Low Back Pain at Home

  • Regular stretching and exercise can help prevent and ease low back pain.
  • When lifting heavy objects, use your legs for leverage, not your back.
  • Walk cautiously and wear shoes with good traction when walking on slippery
    surfaces.
  • When carrying something, be sure to distribute its weight evenly, not favoring one
    side.
  • Consult a spine specialist for severe low back pain that hasn’t resolved with
    conservative methods in a few weeks.

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