Lumbar spinal stenosis – how to treat your symptoms

Usually caused by wear and tear of the spine, lumbar spinal stenosis can lead to back pain and other problems. Find out how it is diagnosed and what treatment is available. 

What are the symptoms?

When to seek urgent medical help 

What causes lumbar spinal stenosis and who’s affected?

Self-care tips

When to see a doctor and getting diagnosed

What’s the treatment? 

Can you prevent lumbar spinal stenosis?

As you age, your spine starts to show signs of wear and tear, which is the main cause of lumbar spinal stenosis. Find out which self-care measures can help the symptoms such as back pain and sore legs, and when you may need to see a doctor. Plus, why surgery may be an option if the condition is badly affecting you.

Spinal stenosis is where the space in the spinal canal – where your spinal nerves and cord are – starts to narrow, causing problems such as pain.

Spinal stenosis can affect your neck (when it is known as cervical spinal stenosis) but when it happens in the lower part of your spine it’s called lumbar spinal stenosis. This is quite common and often causes pain in the leg or legs, and back. 

The good news is that many cases of lumbar spinal stenosis can be managed with self-care steps and non-surgical treatment – from pain relief to physical therapy.


## What are the symptoms?

It’s possible that you may not notice any symptoms of lumbar spinal stenosis. Symptoms can develop gradually and get worse, or they can come on suddenly, for example, due to an injury. Symptoms can include:

- pain or cramps in one or both legs
- aches or burning sensation down the legs
- weakness in the legs or feet
- lower back pain. 

Symptoms will get worse when you are standing, walking, or exercising and improve when you bend forward, sit down, or rest.  


Get help with this

## When to seek urgent medical help 

Contact your doctor urgently if you:

- __notice changes when you go to the toilet__, such as needing to go urgently or more frequently, having difficulty peeing, or you have leaking or incontinence
- __have pain, heaviness, or numbness__ in your legs and find it hard to walk
- have problems with balance
- __experience changes in feeling around your bottom and/or genitals__ such as problems with orgasm or getting an erection. 

## What causes lumbar spinal stenosis and who’s affected?

A healthy spine has enough room for the spinal cord and nerves. However, with age-related wear and tear, this space becomes narrower and irritates sensitive spinal nerves causing pain and difficulty walking or moving. 

Spinal stenosis tends to happen gradually as you get older, affecting people in their 50s and 60s. 

Although it is mostly linked to aging, some health conditions, such as spinal injuries, spinal surgery, [arthritis](https://www.livehealthily.com/health-library/conditions/arthritis), [scoliosis](https://www.livehealthily.com/health-library/conditions/scoliosis), tumors, and disk problems can trigger it at any age. 


## Self-care tips

You may be able to help lumbar spinal stenosis symptoms with:

- __pain relief__ – try over-the-counter painkillers such as ibuprofen, naproxen, or acetaminophen (paracetamol) to manage back or leg pain 
- __heat or ice__ – or both. Heat can help with muscle and joint pain but if it doesn’t, try cold packs, which can ease swelling and inflammation 
- __losing weight__ – maintaining a healthy weight can take pressure off your back and ease symptoms
- __exercise__ – staying fit and strong can help with back pain, if it is safe and recommended for you to do so. Aim for regular exercise, at least 3 times a week for 30 minutes. Check with your doctor, physical therapist, or trainer if you’re not used to exercising 
- __healthy lifestyle habits__ –  quit smoking and reduce your alcohol intake 
- __walking supports__ – using a stick or walker may help you feel more comfortable as you walk by letting you lean into a position that takes pressure off your spine 
- __posture changes__ – adjusting your posture, such as flexing your spine, can help – ask your healthcare professional for advice. 

Although there is no scientific evidence that alternative therapies help long-term lumbar spinal stenosis, some people find that acupuncture, chiropractic treatment, and massage can relieve pain and discomfort.     

## When to see a doctor and getting diagnosed

Lumbar spinal stenosis can often be managed with [self-care](https://www.livehealthily.com/health-library/conditions/lumbar-spinal-stenosis#selfcare). 

However, if your symptoms do not get better within 6 weeks of self-care, or get worse and interfere with your day-to-day activities, then see your doctor. 

To diagnose you, your doctor will ask about symptoms and do a physical exam to locate any pain areas. 

You are likely to need to have further tests such as [X-rays](https://www.livehealthily.com/health-library/medical-exams/x-ray), [MRI](https://www.livehealthily.com/health-library/medical-exams/mri-scan) or [CT scans](https://www.livehealthily.com/health-library/medical-exams/ct-scan) to get a clearer look at your spine. 

## What’s the treatment? 

Treatment for your lumbar spinal stenosis will take into account what’s causing it, where exactly it is, and how bad your symptoms are.

Non-surgical options include:

- continuing [self-care measures ](https://www.livehealthily.com/health-library/conditions/lumbar-spinal-stenosis#selfcare)
- wearing a back brace (best for older patients or people with weak abdominal muscles)
- physical therapy to strengthen your spine and back 
- steroid injections to reduce inflammation and pain. 

If these measures do not help then you may need lumbar decompression surgery to help fix the problem. 

This will most likely be a procedure known as a laminectomy (or hemilaminectomy, a partial laminectomy) where bony fragments are removed from the vertebrae bones in the spinal column, taking pressure off nerves, and reducing pain.

Other procedures include spinal fusion, which joins slipped disks together and stops them causing pain.


## Can you prevent lumbar spinal stenosis?

Although age-related wear and tear is hard to prevent, keeping a strong spine and staying as healthy as you can will help put it off for as long as possible – or at least keep symptoms on the milder side.

As you get older, make sure you are:

- following a healthy lifestyle
- exercising regularly – try strength exercises and techniques such as Pilates for a strong core and back
- maintaining a healthy weight
- correcting your posture to avoid unnecessary pressure on your spine. 

### Support groups

Support organizations can help with information from managing your condition, to talking with others about living with pain. Get in touch with:

- [National Spine Health Foundation (US)](https://spinehealth.org)
- [Pain UK](https://painuk.org)


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References

Juliet Blank

Fiona Bugler

Dr Ewan O'Farrell

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