Top 4 Symptoms Of Spinal Stenosis & Top 4 Treatment Options

Are you looking for help with a lumbar stenosis problem? It’s sometimes called spinal stenosis as well. If we’re talking about lumbar, we mean the lower back. Now, if you have lumbar stenosis, lumbar spinal stenosis, you have probably a little bit of a back problem, maybe a big back problem, and probably some leg problems as well.

I’m going to tell you the top four signs of lumbar spinal stenosis, and then I’ll go over the top four treatment options for lumbar spinal stenosis as well.

My name is Dr. David Middaugh, I’m a specialist physical therapist at El Paso Manual Physical Therapy. We help people with lumbar spinal stenosis problems here all the time, and we have great outcomes with them. They often avoid surgery, avoid living on pain medications and injections, and get back to doing all the things they love to do including walking as long as they want, hiking, gardening, and exercise.

We will go into the details of how to get back to those activities, and we’re realistic about it. If the stenosis is that bad, then we are honest with telling them that it’s that bad, and they might do need a different kind of treatment than what we offer here.

Over the years in treating people with lumbar spinal stenosis problems, we found that there are four signs that are common with just about all of them. We’ve condensed them down for you here, and I’m going to go into each one in depth.

Let’s start with number one, Back Pain

All our stenosis clients, they have had back pain to some degree, some have had small amounts of back pain, that they wouldn’t even consider back pain. They call it more like an achiness, or tightness in the lower back that comes on here and there. It’s not really troublesome for them. And then we have some people that have stenosis problems that have severe back pain, that has been troubling them for years, maybe even decades.

It varies to different degrees, how intense it is, and also how long it’s been there. Some people really don’t think they have had back pain that long. And then there are others that have been dealing with back pain since they have been very young, maybe an old sports injury that kind of kicked it off.

But what we find, in people with spinal stenosis problems, they usually have some sort of history of back pain. Now it’s possible to have back pain without stenosis. But over time as the years go by, and decades go by, stenosis begins to develop instant. Just to be clear, stenosis is where the openings within the spine, where the spinal cord travels and the nerves that come out the sides of the spine, if any of those openings are starting to close up, that’s considered stenosis. Because then you can have a pinching on the nerve.

There is lateral stenosis, which is related to the nerves on the sides of the spine, and then there is central stenosis, which is related to the spinal cord. Usually the central stenosis, which is the worst one to have. You can have a little bit of it and still recover just fine. It’s only a concern if you have it severely, and it’s starting to completely deteriorate. Your legs are affected, other body parts like your bowel and bladder, you may end up having accidents, where you are wetting yourself.

That’s pretty serious stuff, and you need to go to the hospital right away and talk to a doctor about it. Usually surgery is indicated for that kind of situation. So talk to your doctor about that. That’s something to take care of right away.

Going back to the back-pain part, it’s possible to have back pain, and not have stenosis as well. If you’re out there, and you have a back problem, and you are getting scared about, if you might have stenosis, don’t panic or worry just yet. Even if you do have stenosis, it’s often very treatable without any sort of invasive procedures, without any sort of injections or surgeries.

Let’s move on to number two, Leg Pain.

People with spinal stenosis often have pain down into their leg, it could be in the buttock area, in the thigh, either the front or the back of the thigh, even down into the leg, below the knee, and into the heel and foot. People don’t have any pain with this as well. It’s often mistaken for sciatica issue, or a knee pain issue as well. But if you have an imaging done such as X-ray or an MRI, and they showed that you have stenosis, that could be the root of the problem, causing the pain down into the leg.

We often see people have pain in their leg, and it worsens more often than not when they are on their feet and moving around more. It tends to get way better when they sit down. A good way to differentiate if this is sciatica, or if its spinal stenosis is, if when you are sitting down, if the pain is generally relieved, it’s not 100%, but more likely, it’s going to be stenosis. Versus if you sit down and it gets worse, more likely, it’s going to be Sciatica.

Of course, that’s not a black and white thing. Don’t take that as, that’s what he said and this is what I have. It just depends on several factors, but you can use that to begin to gauge if you have more of a static a problem, or a stenosis problem. So, if you sit down and you have some relief because you have been on your feet and it’s been hurting, it more likely is going to be a stenosis problem.

The third most common sign that we find that people that have lumbar spinal stenosis is numbness and tingling into their leg.

It can be in a certain spot, such as on the front of the thigh, or the back of the knee. A common spot we see is on the outside of the lower leg, between the knee and the ankle, even on the side of the shin. That is a very common spot where people will get some numbness, and also into the foot. People frequently get numbness into their big toe, or sometimes in all the toes, or just the top of their foot.

Those are some of the more common areas to get numbness and tingling as well. It feels a if you have ants crawling under your skin. That is a common sensation that people with lumbar spinal stenosis get on their skin. Even though there is nothing on your skin, obviously, it’s just the nerves that are getting compressed from the opening closing., ad it’s starting to affect the nerve and causing that numbness and tingling sensation.

I do have to tell you that if it’s numb and tingly, that’s a bit more serious than just having the pain alone. I encourage you to act on these treatment options that we will talk about here in a second, because it’s starting to get worse if you have got numbness and tingling.

The fourth most common sign of lumbar stenosis is the leg giving out.

What I mean by this is, people have this sensation if they are standing too long, or if they need to climb stairs, or do something that requires a bit more strength from their leg, and then their leg buckles under them. Or oftentimes, in the morning when they are getting up out of bed, they feel like their leg gives out, and it buckles, causes them to lose their balance and have to grab themselves with their arms.

That is a sign of weakness in the muscles that support the leg. Which means that the stenosis has probably gotten bad enough to begin to affect the muscles. This happens slowly over time. What people, that have stenosis tell us, is that it frequently gets more and more intense and worse, to the point where they are scared of having a fall and injuring themselves some other way. So, if the leg is giving out, that is a bad sign. If you have that going on, you need to get help right away.

Let me go into the top four treatment options for lumbar spinal stenosis.

If you have any of these four signs, or all of them, or some combination of them. You want to pay attention here, because here are the most common treatment approaches for lumbar stenosis.

Number one is over the counter pain medications.

Oftentimes, people use anti-inflammatory medication, to calm the nerves down, which can provide some short-term relief. If you go to the doctor and get prescription strength medications that might provide you a little bit more relief. But keep in mind that this is not fixing the stenosis problem. The spinal canal or the openings, for the nerves going out the sides where they are closing, the medications are not opening the pathways for the nerves anymore.

It is simply just calming the pain discomfort for a short time period. Also, keep in mind that the use of these medications over and over again, can have a bad effect on other organs. So if you are out there, and you are dealing with stenosis problems, and you have been taking stuff like Ibuprofen, or stronger prescription strength medications, really considering jumping on a different plan, it’s okay to use medications as long as your doctor tells you to, but just for a short time. You need to have some plan that naturally fix this problem so that you are not relying on those pain medications for the long term. They can cause some serious effects when used over and over again.

The second most common treatment option is injections.

Doctors can give you injected pain medication right into areas where this stenosis is present, so that it can cause an anti-inflammatory effect in the area, and very subtly open up the space. This is short term as well. Once the medication wears off, usually it can last anywhere from a few weeks to a few months. Once that wears off, it’s back to the same problem.

Injectable medication is another option but realize it’s also short term and a lot like the medications that you take by mouth.

The third option is surgery.

You can go have a conversation with an orthopedic spine surgeon about opening up the pathways for the nerves. What they will do is, they will go in and clean out the space around the nerve where the opening is at.

There are other procedures where they can do what’s called a laminectomy, where they can remove a chunk of bone to make the space bigger. Then the more extreme procedure is where they do a spinal fusion, where they put rods and screws, to make sure that the openings for the nerves is stable, and it’s not going to further close down.

These procedures are obviously permanent, once you do them, you can’t undo them, and they are not always 100% successful. The other thing with them is, they expose you to the risk of infection, and sometimes they don’t work all that well. A lot of times they do, and especially if you have that bowel and bladder problem, that I talked about a few minutes ago. If you are having accidents on yourself, it’s likely going to benefit you a lot, to go have a procedure done to make sure that the nerve pressure is off, and your bowel and bladder functions work well. So you are not having accidents all the time. That’s really important.

Also, if you have immense leg weakness. I’ve seen some people in wheelchairs because of this problem. It might be a great idea to go talk with a surgeon and see if you can get the pressure off the nerves, to get your leg function back before it becomes really, really bad.

But now if you’re just dealing with the lesser symptoms that I’ve talked about, surgery is probably not anywhere near happening for you. But it is something that is done later on if it gets really bad.

If you want to avoid surgery, the fourth treatment option is definitely going to be your best one, especially if you want to avoid medications and injections, which is to get physical therapy treatment.

It is shown to be tremendously helpful for lumbar spinal stenosis. The conversation that I usually have, as a specialist physical therapist, with a client coming in for a lumbar stenosis is about how to open those narrowing spaces more. Because the thought is that once it closes down, it stays closed down. But the reality is, especially for the openings that are on the sides of the spine is with exercise, strengthening, and hands on work, those spaces can open more and stay open.

It is possible for the individual with the back problem, with the stenosis problem, to keep that space open using exercises that they can do on their own. Here in physical therapy, we do the hands-on work to open up the spaces where the nerves come out in their lower back. We help them with the exercises and show them how to do the exercises on their own, and progress them, and maintain them so that it’s something they can do on their own at home and keep the spaces open.

That way they can reduce the leg pain, the pain going down their leg, the numbness and tingling that might appear, and get control over their legs giving out, so that they feel more balanced and able to walk around with confidence, and hopefully don’t have to rely on a cane for a long period of time. Of course, it helps the lower back pain as well.

All this is done naturally. We don’t do medications, injections, and of course, not surgery as well. But we do this in a way where we teach the individuals how to help themselves. We boost it with what we do here in the clinic, the hands and the exercises and guidance on how to treat this problem. But we definitely impart the knowledge on each individual that comes through, so that they can manage their own stenosis problem for the long term, and keep doing what they love without having to end up in a surgeon’s office, or frequent a doctor’s office for pain medications and injections.

I hope this was helpful for you. If you have questions, please contact us, you can reach us at 915-503-1314. If you think you’d like to hire us to help you with your lumbar stenosis problem, or you at least want to have a conversation about if we can help you or not, I encourage you to call us at 915-503-1314 and ask about a discovery visit.

A discovery visit is a 20-minute visit where we get to meet you, you get to meet us, and you get to talk to a specialist physical therapist about your lumbar stenosis problem, and we can understand your story what’s going on with your symptoms and see if we’re the best fit for you. So that we can begin to formulate a plan on how to solve your lumbar stenosis problem without having to rely on medications, injections, and hopefully skipping out in surgery completely. I wish you the best of luck bye bye!