Recently, we addressed the topic of claudication. Claudication refers to pain typically felt in the legs as a result of vascular (blood vessel) problems or back problems (such as spinal stenosis) that can cause pinched nerves in the lower back.
Neurogenic claudication is a common symptom of lumbar spinal stenosis, which is the abnormal narrowing of the spinal canal in the lumbar (lower) spine. Neurogenic refers to the condition’s genesis in the nerves, while claudication (Latin for limp) refers to painful weakness or cramping in the legs.
Also called pseudoclaudication, neurogenic claudication occurs as a result of compression of the nerves in the lumbar spine. Neurogenic claudication is widely considered a syndrome, meaning that it involves a group of symptoms that usually develop collectively.
As aforementioned, most cases of neurogenic claudication are triggered by spinal stenosis, which occurs when the space around the spinal cord diminishes.
Spinal stenosis is estimated to affect 8% to 11% of adults in the United States, according to the American Academy of Orthopedic Surgeons. It’s the most prevalent in adults over the age of 50.
Common causes of spinal stenosis include bone spurs, bulging discs, and the thickening of ligaments in the spine.
These spinal conditions can trigger the impingement of spinal nerves, which leads to the symptoms associated with neurogenic claudication.
This syndrome may be bilateral (in both legs) or unilateral (in one leg). However, most cases of neural claudication are bilateral.
Symptoms of neural claudication typically include pain, cramping, weakness, and tingling. These symptoms most often appear in one or both legs, the lumbar spine, and the buttocks.
Pain from neural claudication may be triggered by walking or prolonged standing and is generally alleviated by changing position or bending the waist. Unlike vascular claudication, neural claudication can’t be alleviated simply by resting.
In severe cases, pain from this syndrome may be persistent. Without treatment, spinal stenosis and neural claudication can become a source of chronic pain.
First, your physician will need to run tests to provide a diagnosis. An x-ray, MRI, and CT scan are all often used to diagnose neural claudication and can identify stenosis, bone spurs, and slipped discs.
These tests can evaluate the general condition of the spinal bones and soft tissues to determine if neural claudication is present. This, along with a physical exam and patient interview, will help your physician diagnose your spinal symptoms.
Conservative treatments may be sufficient to relieve neurogenic claudication. Physicians generally start patients out with a conservative treatment plan before considering surgery.
Some of the most common non-surgical treatments for neurogenic claudication include:
Physical therapy for neural claudication usually involves exercises for spinal flexion, abdominal exercises to improve stability, and lifestyle recommendations. Massage and heat/ice therapy may also be implemented for pain relief.
Anti-inflammatory medications can help relieve pain and inflammation caused by neurogenic claudication. These medications may be found over-the-counter or prescribed, depending on the severity of the case.
Epidural steroid injections can be used to relieve pain from irritated nerves in the spine. When injected into the affected area, the steroid medication works to reduce pain signals from the injured nerves, leading to less pain and discomfort.
Keep in mind that epidural steroid injections should generally only be applied three to six times annually. If you get too many injections, there’s a risk of decreasing the strength of the vertebrae and adjacent muscle tissue.
In moderate to severe cases of neurogenic claudication that don’t respond to conservative protocols, surgery may be recommended. Spinal decompression surgery can improve your comfort and quality of life if neurogenic claudication is interfering with your daily activities.
Spinal decompression surgery is typically performed to remove portions of the vertebrae that are impinging on a nerve. This pinched nerve is the source of pain, weakness, and cramping in cases of neurogenic claudication.
Any procedure that relieves pressure on spinal nerves to resolve symptoms of spinal compression, including neurogenic claudication, is referred to as spinal decompression surgery. There are a few different approaches to spinal decompression, including discectomy, laminotomy, laminectomy, foraminotomy, foraminectomy, corpectomy, and osteophyte removal.
Your surgeon will determine the best method of spinal decompression to suit your circumstances.
Following the spinal decompression treatment, a secondary operation is performed to stabilize the spine in the area where vertebral material was removed. In the past, spinal fusion back surgery was the sole available surgical stabilization procedure performed with spinal decompression.
Spinal fusion involves connecting neighboring two vertebrae so that they eventually form one bone. To do this, the surgeon will position bone graft material in between the vertebrae.
To keep the vertebrae in position during the bone graft’s healing process, your surgeon may also perform posterior fixation. This involves using screws and rods to reinforce the alignment of the spine.
Although spinal fusion can prevent further damage from spinal instability, it has several downsides. For one, patients commonly need to stay in the hospital for up to four days after spinal fusion. After the patient returns home, it can take many months for the vertebrae to fuse together and for the spine to heal.
Spine fusion surgery eliminates the natural independent motion of the fused vertebrae. It can contribute to the deterioration of adjacent vertebrae, potentially leading to further complications.
Additionally, spinal fusion compromises the mobility of the spine. Patients may require special tools to pick up items off of the floor because they can no longer bend over after spinal fusion.
The TOPS (Total Posterior Solution) System provides an alternative to spinal fusion that preserves the full range of natural motion of each vertebra. It’s a mechanical device that supplants the tissues removed during spinal decompression.
With the TOPS spinal implant, it’s possible to reinforce the stability of the spine after spinal decompression surgery without compromising the patient’s range of movement. This device moves with the spine so that the patient can resume their normal activities soon after surgery.
The TOPS device also provides a faster, more comfortable recovery process after spinal decompression. This spinal implant reduces the trauma on the spinal tissues after decompression.
If you experience pain that interferes with your quality of life, seek qualified medical help and get the facts about all of your treatment options. Today’s advanced procedures provide excellent outcomes for spinal conditions including neural claudications.
All patients undergoing back surgery should actively ensure that the healing process goes as smoothly as possible. In doing so, you can attain the best possible results from the procedure while avoiding complications that could compromise your health.
Proper incision care is a key step in the process of adopting healthy habits and positive lifestyle choices to promote healing. As an aspect of your spinal surgery recovery, incision care will benefit your overall health.
Here, we’ll discuss how to care for a spinal incision to ensure a successful surgical recovery and back pain relief. Additionally, we’ll explore innovations in the field of spine surgery that allow for smaller incisions and, as a result, a lower risk of complications.
After spinal surgery, the incision may be closed with Steri-Strips, staples, or sutures, including dissolvable sutures. Most often, spinal surgeons use a combination of these closure methods.
Since spinal surgery is performed beneath the layers of skin and muscle in the back, the incision must be closed at various layers. Your surgeon will suture the muscle layer together before closing the skin.
In preparing for back surgery, patients should begin on a path of improving their diet and physical activity. These practices will improve your overall health to ensure that the spinal surgery goes off without a hitch.
With that said, implementing healthy habits is not only essential for the surgery itself but also for the recovery process following the operation. While continuing the positive lifestyle changes that you applied before the procedure, make sure to rigorously follow your doctor’s orders, including those about what medications to avoid. Certain medications can interfere with the healing process, namely including NSAIDs. NSAIDs, like aspirin, ibuprofen, and naproxen, are blood thinners and can impair the body’s repair processes.
Proper care for the surgical incision is one of the most important aspects of post-operative home recuperation following back surgery.
You won’t be permitted to apply any ointments or lotions to the incision while it’s healing. You also shouldn’t bathe in a tub, swim, or use a hot tub until your incision is healed. Immersing the incision in water before your surgeon clears you to do so may increase your risk of infection and inhibit the healing process.
Additionally, you’ll need to keep the incision clean after spinal surgery. You can clean the incision site with soap and water, then gently dry it with a clean cloth. This helps prevent infection as the incision heals.
In most cases, non-dissolvable sutures and staples are removed 14 days following the spinal surgery. At this point, the incision is usually fully healed.
Many spinal surgery patients are eager to reduce scarring by applying scar treatments and vitamin creams to the incision. However, you must wait to get the go-ahead from your surgeon before doing so. Typically, surgeons allow patients to start applying scar creams six weeks after the procedure.
It generally takes about two weeks for a spinal incision, including a spinal stenosis incision, to completely heal. At this point, your surgeon will remove sutures and staples, as well as clear you to take baths and swim. However, this timeline can vary from patient to patient.
Spinal incision infections typically appear two to four weeks after the procedure. Your surgeon will advise you to be aware of infection symptoms, which include fever, worsening redness at the incision, and changes in the infection drainage. If any of these symptoms occur, make sure to reach out to your surgeon immediately.
Additionally, if the surgeon places any hardware or devices during the procedure and an infection develops, they may need to be removed. This also applies to patients with an implantation spinal cord stimulator incision or spinal fusion incision.
Immediately after the spinal nerves are decompressed in surgery, the healing process can begin. But, nerve tissue heals far slower than other types of tissue in the body, namely muscle tissue. So, while some patients will experience an immediate improvement in nerve pain after spinal surgery, other patients may need more time to notice a difference.
In the weeks and months after spinal surgery, patients should notice a gradual improvement in neurological symptoms such as numbness, tingling, and weakness. By adopting healthy lifestyle habits, such as engaging in low-impact exercise, eating healthily, and refraining from smoking, you can ensure that the spinal nerves heal as quickly as possible.
Surgeons always aim to create as small an incision as possible while successfully carrying out the procedure. This is because a smaller incision leads to less blood loss, less scarring, and a lower risk of infection.
Fortunately, the last several years have seen a revolution in back surgery procedures and outcomes. Now, more minimally-invasive procedures are available to patients that require spinal surgery. These procedures allow for much smaller incisions, among other advantages over traditional open back surgery.
One procedure that can now be replaced with minimally-invasive alternatives is spinal fusion back surgery. This procedure was traditionally performed in conjunction with spinal decompression surgery for spinal stenosis, spondylolisthesis, and related conditions.
Spinal fusion involves positioning an implant containing bone graft material in between the affected vertebrae. Over the course of several weeks after the procedure, the bone graft will trigger the fusing of the vertebrae, turning them into a single bone. As a result, the patient can avoid spinal instability after decompression surgery.
Unfortunately, spinal fusion requires a long recovery period and eliminates the natural movement of the individual vertebrae. It also creates the risk of adjacent segment disorder, or ASD, which occurs when the vertebrae surrounding the fused segment degenerate more rapidly than they otherwise would.
Thankfully, a spinal fusion alternative has emerged to improve outcomes and preserve patients’ range of motion: the TOPS (Total Posterior Solution) System. The TOPS System is an implant that facilitates a minimally-invasive spinal surgery. It’s been shown in clinical trials around the globe to provide superior outcomes for patients who undergo treatments such as lumbar laminectomy or other spinal decompression procedures for various causes of lower back pain.
As the example of the TOPS System indicates, these advances in minimally-invasive back surgery allow for not only fewer complications in surgical incision healing, but also improved outcomes overall.
Don’t hesitate to discuss concerns surrounding post-op incision care with your surgeon, and make sure to explore all of your spine surgery options.
Your lower back is more susceptible to injury than the other regions of the spine. So, it’s unsurprising that a pinched nerve in the lower back is among the most common spinal injuries. Though a pinched lumbar nerve can often clear up on its own, some patients may need medical attention to resolve their symptoms.
This article will answer the most common questions about having a pinched nerve in the lower back, including the available treatment options.
A pinched nerve is a condition that can cause pain and restrict one’s mobility. It develops when adjacent tissue, such as bone, muscle, or cartilage, impinges on a nerve. This can lead to various neurological symptoms, namely weakness, tingling, and numbness in the extremities.
Though pinched nerves can occur almost anywhere, the spine and, in particular, the lumbar region of the spine, account for a significant percentage of cases. This is due to the spine’s complex structure and the fact that the lower back experiences more strain with motion than the cervical or thoracic spine. This condition is referred to as a pinched lumbar nerve or a pinched nerve in the lower back.
The nerves of the lumbar spine extend throughout the pelvis, legs, and feet. The sciatic nerve, for example, is the longest nerve in the body and runs from the lower back through the hips and down the backs of the legs. A pinched sciatic nerve can cause persistent back pain, tingling, and other symptoms that are referred to as sciatica.
The symptoms of a pinched nerve in the lower back include lower back pain that radiates to the buttocks, legs, and feet, along with weakness, numbness, and tingling in the extremities. Pain from a lumbar pinched nerve may be described as sharp, electric, burning, stabbing, or stinging.
In some cases, a pinched nerve in the lower back may also cause muscle spasms, the sensation of the feet “falling asleep”, or a “pins and needles” sensation. These symptoms can vary depending on the severity of the nerve impingement, along with the patient’s overall health.
Spasms in the leg muscles may result from a pinched nerve in the lower back because of abnormal nerve signals. Nerves send signals to muscles throughout the body, causing them to engage. When a nerve in the lower back is pinched, it may send unnecessary signals to the leg muscles, leading to spasms.
All of these symptoms (radiating pain, numbness, tingling, weakness, and leg muscle spasms) are often described by the term radiculopathy. Lumbar radiculopathy is defined as a condition resulting from a pinched nerve in the spine, and it occurs in an estimated 3 to 5% of the population.
Some people experience a symptom known as “foot drop” from a pinched nerve in the lower back. With this symptom, it’s difficult to lift the front area of the foot. So, the foot tends to slap onto the ground when you walk.
Foot drop can make it difficult to walk around, even for short distances (in advanced cases). If foot drop severely compromises your mobility, your physician may recommend a more aggressive treatment plan to resolve the nerve impingement, like surgery.
Sometimes, a pinched nerve in the lower back can escalate, leading to a condition known as cauda equina syndrome. This dangerous condition can lead to permanent neurological damage if it’s not promptly treated. So, if you have a pinched nerve in the lower back, keep an eye out for the following warning signs of cauda equina syndrome:
If you experience the warning signs listed above, seek out emergency medical care.
A pinched nerve in your back may feel like sharp, shooting pain, a burning sensation, weakness in the legs, and/or tingling. In mild cases, patients may experience only minor discomfort or back pain that comes and goes.
The symptoms of a pinched nerve vary depending on the exact nerve and the extent of the pressure. In addition to the symptoms listed above, this condition can cause a loss of reflexes and motor skills, as well as atrophy of the affected muscles.
The symptoms of pinched nerves will go away on their own if the pressure on the nerves is only temporary. If this is the case, patients will regain the full function of the spine without the need for medical intervention.
It typically takes four to six weeks for a pinched nerve to go away on its own. To manage your symptoms while this spinal injury naturally heals, consider at-home treatment options like rest and over-the-counter pain medications. While you’re resting with a pinched nerve, make sure to avoid activities that may strain the affected area of the spine, such as:
You can perform some forms of exercise but not others with a pinched nerve. Gentle, low-impact exercises that don’t strain the spine are considered beneficial for a pinched nerve in the back. This is because they promote circulation, muscle strength, and flexibility.
The best forms of exercise for a pinched nerve in the back include:
Forms of exercise to avoid with a pinched nerve in the lower back include:
If your pinched nerve doesn’t go away on its own, there are many treatment options available to you. These include:
A physical therapist can provide special exercises to help resolve pinched nerve symptoms. These exercises focus on strengthening the abdominal muscles to better support the spine and stretching the back to alleviate muscle tension.
Spinal manipulation may help ease the symptoms of a pinched nerve by relieving pressure on the affected nerve and promoting circulation to the area.
Over-the-counter and/or prescription medications may be used to reduce tension in the back muscles and alleviate inflammation in the painful area of the back.
Massage therapy is often good for pinched nerves in the lower back. This is because it can help alleviate muscle tension that may be causing or worsening nerve impingement. As a safe and natural treatment option, massage therapy is widely used by patients to help with pain and stiffness from a pinched nerve.
There are many different types of massage, but the most popular for pinched nerves in the back include deep tissue massages and Swedish massages. Make sure to visit a licensed and reputable massage therapist to prevent further irritating the impinged nerve.
A chiropractor can treat a pinched nerve with manual adjustments, along with remedies like heat/cold therapy and lifestyle changes.
During a chiropractic adjustment, the chiropractor will use their hands or a small instrument to manipulate the spine. This helps restore the proper alignment of the spine, reduce pressure on the spinal nerves, and promote circulation to the injured area.
For virtually any condition, the best therapy is preventive. Pinched nerves and many other spinal problems can be avoided by:
To get rid of a pinched nerve in your back that doesn’t respond to non-surgical treatments, you may want to consider surgery.
When preventative measures and non-invasive treatments fail, surgery for a pinched nerve is a viable option. Spine specialists don’t consider surgery for a pinched nerve in the back unless the patient has undergone six to 12 months of conservative therapies with no notable improvement. Additionally, candidates for pinched nerve surgery typically have severe, chronic pain that diminishes their ability to complete day-to-day tasks.
Spinal decompression surgery is recommended for some patients who don’t respond to minimally-invasive treatments for a pinched nerve. Spinal decompression therapy can have a dramatic effect on relieving the symptoms of a pinched nerve in the lower back.
The most common form of spinal decompression surgery for a pinched nerve in the back is laminectomy. During this operation, the surgeon removes a small piece of the bone that covers the spinal canal, known as the lamina. Removing some of this bone allows the surgeon to create more space for the affected nerve and resolve the impingement.
Typically, spinal fusion back surgery is performed in conjunction with decompression surgery to stabilize the spine. Without some form of stabilization, decompression surgery can leave the spine vulnerable to future injury.
Spinal fusion is performed after decompression surgery. During the procedure, the surgeon positions bone graft material in between the affected vertebrae. Gradually, this bone graft will cause the vertebrae to combine into one bone.
This process eradicates all motion between the fused vertebrae, which prevents injuries related to instability of the area. Unfortunately, it also permanently reduces the patient’s mobility and can cause degeneration in the adjacent spinal segments.
Today, the TOPS (Total Posterior Spine) System provides an alternative to spinal fusion for a pinched nerve in the back. In contrast to spinal fusion, TOPS restores the full range of the spine’s natural motion. It’s also been shown to provide superior outcomes when compared to fusion in clinical studies performed around the world.
The TOPS System presents a great new option for some individuals affected by pinched nerves in the lower back. Contact a medical center that offers the TOPS System in your area to learn more!
Have you heard of radiculopathy? This condition results from nerve irritation and, if it progresses, can induce debilitating symptoms. If you’ve already been diagnosed with radiculopathy, you know that it can alter your ability to complete day-to-day motions and activities.
Understanding radiculopathy, what causes it, and what symptoms it triggers can help you more effectively cope with this neurological condition.
Radiculopathy is a term that refers to chronic injuries resulting from the bones of the spinal column (vertebrae), or the cushioning discs between them, impinging on a nerve root in the spinal column. With this condition, the affected nerve root is irritated or inflamed, leading to a variety of neurological symptoms.
Any part of the spine can be affected by radiculopathy. With lumbar radiculopathy, the condition can trigger lower back pain that spreads down to one or both legs.
Common symptoms of radiculopathy include numbness, tingling, weakness, loss of motor function, muscle spasms, and radiating pain.
The symptoms of radiculopathy may be felt all the way to the tips of fingers or toes, even though the nerve compression occurs at the base of the nerve in the spine. This is because spinal nerves extend from the spinal canal throughout the body, supplying sensation to the extremities.
Radiculopathy can be serious if it’s left untreated. In other words, radiculopathy symptoms become more serious with time when a patient fails to receive professional medical care.
When it’s promptly addressed, radiculopathy often improves within six to 12 weeks. Many radiculopathy cases even resolve with at-home care alone, without the need for medications or hands-on treatments.
Most patients can work with radiculopathy. Although it can affect your ability to work, in severe cases, radiculopathy most often goes away with rest and at-home treatments.
When radiculopathy persists longer than a few weeks, it can start to affect your work. This is particularly true for patients in careers that require physical exertion, such as construction, warehouse work, landscaping, agricultural work, firefighting, and professional athletics.
Surprisingly, radiculopathy can even inhibit your ability to work if you have a sedentary job. This is because lumbar radiculopathy can lead to debilitating pain in the lower back and legs with prolonged periods of sitting. With this in mind, patients who have been diagnosed with radiculopathy and have desk jobs should try to take a break from sitting at least once every hour.
Radiculopathy can become a permanent disability over time.
Patients who are suffering from lumbar radiculopathy may be eligible to reap disability benefits. Eligibility requirements can vary depending on your disability insurance plan.
Radiculopathy may be considered a disability because it can be debilitating, making it difficult to work. Severe radiculopathy can diminish a patient’s ability to walk, stand up, move around, and remain seated for extended periods.
An MRI can show radiculopathy. It’s considered the gold standard of imaging modalities to diagnose radiculopathy.
Generally, an MRI is used to confirm a radiculopathy diagnosis, even if the doctor is confident of the diagnosis after a physical examination. MRIs can clearly display nerve impingement in the spine and even show any structural lesions that are irritating the affected nerve. This makes MRI scanning an invaluable tool for spinal specialists as they diagnose radiculopathy and other conditions that affect spinal nerves.
The most common cause of radiculopathy is spinal degeneration associated with the normal aging process. Age causes the spinal structures to weaken and lose flexibility. As the spine shifts as a result of these changes, nerve root irritation can occur.
Whether due to spinal stenosis, spinal disc herniation, or bone spurs, spinal degeneration can narrow the openings where nerve roots exit the spine, known as foramina. This condition may be referred to as foraminal stenosis and can lead to nerve root compression. When a spinal nerve root becomes irritated and inflamed, it can result in symptoms of radiculopathy.
Besides spinal degeneration, radiculopathy can be caused by a range of other factors, including:
Additionally, genetic predisposition and the presence of other spine disorders can increase one’s risk of developing spinal radiculopathy.
Radiculopathy is treated with rest, physical therapy, and anti-inflammatory medication, in most cases.
In some mild cases, radiculopathy resolves on its own over time, without the need for treatment. However, patients with persistent symptoms that don’t gradually improve should visit a physician for a treatment plan. Some severe cases of radiculopathy require surgery to restore patients’ mobility and quality of life.
Physical therapy helps radiculopathy by strengthening the muscles in the abdomen and back that support the spine. Greater muscle strength in these areas will alleviate some pressure from the irritated nerve root, leading to reduced symptoms.
Additionally, physical therapy helps radiculopathy by improving the patient’s body mechanics. This facilitates a balanced distribution of weight with day-to-day motions, which helps alleviate pressure on the affected nerve root.
Physical therapists may also implement a variety of alternative treatment methods to ease radiculopathy symptoms, including massage and dry needling.
Massage helps reduce muscle tension, which can ease the muscle spasms associated with radiculopathy. Additionally, massage offers anti-inflammatory benefits, helping to reduce the swelling and irritation around the nerve root.
Dry needling is a treatment that involves inserting thin filiform needles into myofascial trigger points. This process reduces muscle tension, boosts blood circulation, and eases pain. A 2021 study found that trigger point dry needling can effectively decrease pain in patients with lumbar radiculopathy.
Your physical therapist may include massage and dry needling in your radiculopathy treatment plan alongside stretching and strengthening exercises.
A chiropractor can help fix radiculopathy by addressing structural imbalances in the spine. This can alleviate nerve irritation and lessen the patient’s pain.
A study published in the Journal of Chiropractic Medicine evaluated the clinical outcomes of 162 patients with radiculopathy treated with chiropractic care. Of these patients, 85.5% experienced a resolution of the main subjective radicular complaints after nine treatment sessions.
Chiropractic adjustments involve a chiropractor manually manipulating the spine to improve its alignment. This process also improves spinal mobility and creates more space around the irritated nerve, allowing blood, oxygen, and healing nutrients to reach the injury.
Additionally, chiropractors may implement non-surgical spinal decompression to treat radiculopathy. During non-surgical decompression, the chiropractor implements a motorized traction device (a table with a harness and motor) that gently pulls the spine, creating more space between the vertebrae.
A 2022 study published in BMC Musculoskeletal Disorders evaluated the effects of non-surgical decompression therapy with physical therapy for radiculopathy, compared to physical therapy alone. The study found that the combination of non-surgical spinal decompression therapy and physical therapy was statistically and clinically more effective than physical therapy alone for lumbar radiculopathy patients. It was more effective for improving lumbar range of motion, functional disability, quality of life, and back muscle endurance.
A neurologist can establish a treatment plan to restore sensation and alleviate pain for radiculopathy patients.
Neurologists specialize in the diagnosis and treatment of nerve, brain, and spinal cord disorders. They may recommend physical therapy, chiropractic care, medication, or even surgery to resolve radiculopathy symptoms.
For patients whose radiculopathy doesn’t improve with several months of conservative treatment, spinal decompression surgery may be recommended.
During this procedure, the portion of a vertebra impinging on the nerve root is trimmed away. This can provide dramatic relief from radiculopathy symptoms while giving the irritated nerve space to heal.
Traditionally, spinal fusion back surgery has been performed in conjunction with spinal decompression. Spinal fusion is used to stabilize the spine at the point of the operation, preventing future injury and discomfort. Unfortunately, spinal fusion also comes with its own risks and complications.
Spinal fusion eliminates the natural independent motion of the fused vertebrae, which can compromise patients’ ability to enjoy various physical activities. This procedure may also contribute to the deterioration of adjacent vertebrae, creating the risk of future back pain and neurological symptoms.
Today, there’s an alternative to spinal fusion for lumbar radiculopathy: the TOPS™ (Total Posterior Spine) System implant. This revolutionary device preserves the natural motion of the spine and allows movement in all directions.
Clinical studies have shown that it provides superior clinical outcomes for patients with chronic lumbar spine disorders like radiculopathy, spinal stenosis, and spondylolisthesis. It has been shown in clinical studies around the world to provide better clinical outcomes than spinal fusion.
With major medical advances rapidly being released, patients must remain up-to-date on the latest treatment options for chronic back pain. Talk to a spine specialist in your area to learn more about emerging therapies like the TOPS™ System.
The human body contains an extensive system of nerves that facilitate communication between the cells. Nerves send and receive messages throughout the body. Without them, we wouldn’t have basic human functions, like movement, balance, and sleep, or sensations, like touch.
Unfortunately, just like the rest of the human body, nerves are susceptible to damage. Radiculopathy is one type of nerve damage that can severely impact one’s mobility and quality of life.
In this article, we’re going to discuss a specific form of this nerve condition: lumbar radiculopathy.
The vertebrae are the bones of the spine. An intervertebral disc is located in between each vertebra and acts as a cushion by absorbing impact.
If the vertebrae or the discs between them impinge on a nerve root in the spinal column, chronic nerve injuries may result. Radiculopathy is the general term for these injuries.
Radiculopathy most commonly occurs in the lower, or lumbar, region of the spine. This condition has been termed lumbar radiculopathy. Though less common, radiculopathy may also occur in the neck, or cervical region of the spine, which is known as cervical radiculopathy.
Common symptoms of radiculopathy include radiating pain, numbness, tingling, and weakness. In some cases, a loss of motor function can result from lumbar radiculopathy. These symptoms may be felt all the way to the tips of the fingers or toes, even though the nerve injury is at the base of the spine.
Radiculopathy symptoms felt in the arms and hands are usually caused by cervical radiculopathy, while those in the back of the leg and the foot usually result from lumbar radiculopathy. The location of the nerve compression determines where radiculopathy symptoms are felt.
The severity of lumbar radiculopathy symptoms can vary from patient to patient. Some patients with radiculopathy experience severe, debilitating symptoms that significantly impact their day-to-day activities.
There are several possible causes for lumbar radiculopathy, including:
Degenerative disc disease is a normal part of the aging process. It occurs when the intervertebral discs weaken and dry out over time. As the discs become damaged, the nerves of the spine may become irritated, leading to radiculopathy symptoms.
Repetitive and high-impact motions can contribute to lumbar radiculopathy. This is more common among people with occupations that require repetitive motions or heavy lifting.
Being overweight or in poor physical health can also contribute to radiculopathy. This is because added body weight puts extra stress on the nerves, which can lead to nerve damage.
Diabetes is associated with heightened blood glucose levels. This can cause the development of deposits within the blood vessels that decrease circulation throughout the body. As a result, high blood sugar can lead to nerve damage.
A genetic predisposition can also increase one’s risk of developing spinal radiculopathy.
Various spinal conditions can cause nerve impingement and lead to radiculopathy. Examples of these conditions include herniated disc, spinal stenosis, osteoarthritis, spondylolisthesis, and scoliosis.
Sciatica is a form of radiculopathy. In fact, it’s the most prevalent type of radiculopathy. It refers to pain that radiates throughout the sciatic nerve, meaning that it starts in the lower back and moves through the buttocks, down the legs, and to the feet.
The terms lumbar radiculopathy and sciatica are commonly used interchangeably. This is because nerve impingement in the lumbar spine typically involves the sciatic nerve. After all, the sciatic nerve is the largest nerve in the body.
Lumbar radiculopathy has the potential to get worse. In some patients, the pain may come and go. But, in others, radiculopathy symptoms are persistent and gradually become worse over time.
If lumbar radiculopathy isn’t promptly addressed, various factors can exacerbate the condition by causing additional nerve damage. These factors include:
Poor posture increases the amount of stress placed on the spinal nerves. In patients who lead a sedentary lifestyle, sitting at a desk with poor posture for hours on end may significantly worsen radiculopathy symptoms.
Repeatedly twisting, bending, and straining the spine can further irritate the affected nerves, leading to worsened radiculopathy symptoms.
Weight-bearing physical activities can cause additional damage to the spinal nerves. Examples of these activities include football, wrestling, weightlifting, soccer, and hockey.
Lumbar radiculopathy treatment methods may be non-surgical or surgical. Doctors begin with non-surgical treatment, and if the patient’s symptoms don’t improve after several months, consider surgery.
Physical therapy, medication, steroid injections, and relaxation are often prescribed successfully to treat lumbar radiculopathy.
Physical therapy is often recommended for lumbar radiculopathy. It involves exercises and therapies designed to improve spinal stability and alignment. This can help create more space for the spinal nerve roots.
Non-steroidal anti-inflammatory drugs, or NSAIDs, can help relieve inflammation and pain caused by lumbar radiculopathy. This can help make radiculopathy symptoms more manageable. However, these medications generally aren’t recommended for long-term use.
Epidural steroid injections reduce the body’s inflammatory response at the injection site. For lumbar radiculopathy, this can help alleviate inflammation in the spinal nerves.
Doctors generally advise patients to receive no more than three to four epidural steroid injections per year. Since steroid injections hamper the immune system response, they can cause tissue damage when used in excess.
Rest and relaxation are recommended for patients with lumbar radiculopathy to give the spinal nerves time to heal.
When non-surgical treatments fail to provide relief for radiculopathy of the lumbar region, surgical methods may be recommended. Generally, physicians don’t recommend surgery for lumbar radiculopathy unless the patient has undergone at least six months of conservative treatment.
Spinal decompression surgery is the main surgical lumbar radiculopathy treatment. This type of spine surgery involves removing spinal tissues to alleviate pressure on the affected nerves. Laminectomy, laminotomy, laminoplasty, foraminotomy, and discectomy are all common methods of spinal decompression.
Since spinal decompression surgery involves removing tissues from the spine, it can lead to spinal instability. To prevent this, spinal decompression surgery is often combined with spinal fusion back surgery. This combination of procedures has been a common treatment modality for lumbar radiculopathy patients who don’t respond to conservative treatments.
Spinal fusion permanently joins the affected vertebrae using bone graft material. This prevents all motion in the fused spinal segment. Unfortunately, while this counters instability, it also significantly decreases the patient’s range of motion.
Additionally, fusing two spinal vertebrae forces the adjacent vertebrae to bear additional impact with day-to-day motions. The added impact can cause the adjacent spinal segments to deteriorate at a quicker rate, potentially leading to back pain, stiffness, and neurological symptoms. This complication of spinal fusion is known as adjacent segment disease or ASD.
The TOPS™ (Total Posterior Spine) System is a new advancement in spinal surgery that can be used as an alternative to spinal fusion. Unlike fusion, the TOPS™ System preserves the full natural range of motion of the individual vertebrae, which is lost when the bones are fused.
This spinal implant has also been shown to provide superior outcomes in clinical studies conducted across the globe. With TOPS™, lumbar radiculopathy patients can attain lasting relief for nerve pain without having to worry about complications from spinal fusion.
Advances like TOPS™ give individuals with back problems more options for effective treatments. So, if you’re suffering from persistent radiculopathy pain, speak with a spine specialist about the complete range of treatment solutions available today.
Spinal stenosis is a prevalent spinal disorder in the U.S. and across the globe. In fact, the condition affects an estimated 250,000 to 500,000 U.S. residents.
This spinal disorder can occur in the lower, or lumbar, region of the spine, which is known as lumbar spinal stenosis. Or, it may occur in the neck, or cervical, region of the spine, which is known as cervical spinal stenosis. Lumbar spinal stenosis is the most common form of this condition, and it’s the topic of our article.
Spinal stenosis is a common condition, especially among patients who are aged 50 and over. It occurs when the spinal canal abnormally becomes narrower. The word “stenosis” can be traced back to ancient Greek and refers to narrowing, or constriction.
As the spinal canal progressively narrows over time, it strains the nerves that extend outward from the spine and travel into the extremities. This can cause a range of symptoms.
The symptoms of lumbar spinal stenosis can differ from patient to patient. However, pain, tingling, and numbness in the extremities are among the most common signs of this spinal disorder.
Other symptoms of lumbar spinal stenosis may include:
There might be other non-specific symptoms of spinal stenosis. So, please consult with your doctor for a precise diagnosis.
Most cases of spinal stenosis occur for unknown reasons. However, the causes of lumbar spinal stenosis are rooted in specific parts of the spine’s anatomy, such as:
An intervertebral disc is located between each of the bones in the spine. It provides cushioning for the bone and prevents damage by absorbing impact. These discs break down with age and may even become herniated, meaning that the disc interior protrudes from a crack in the disc interior.
A damaged intervertebral disc can take up extra space in the spinal canal, potentially leading to spinal stenosis.
The facet joints connect the vertebrae of the spine to one another. These joints support a large amount of weight and undergo a significant amount of stress. As a result, they’re vulnerable to wear and tear, as well as various injuries. Damage to the facet joints (and the cartilage within these joints) can trigger spinal stenosis.
When the spinal cord and/or the nerve roots become compressed, it may trigger pain and neurological symptoms. When the spinal cord and nerve roots are involved in spinal stenosis, the patient is rarely asymptomatic.
The narrowing, or tightening, of the spinal canal, may result from abnormal bone and/or tissue growth. or due to a hereditary disorder. This is referred to as inherited spinal stenosis.
Some people are born with a spinal canal that’s narrower than average. This can cause the patient to experience spinal stenosis symptoms much earlier in life than the average patient. Additionally, patients who are born with scoliosis may experience spinal stenosis.
Scoliosis is an atypical, sideways curve of the spine. It’s commonly recognized and diagnosed in children and adolescents. In patients with scoliosis, the curved spine may place stress on the spinal cord, potentially leading to spinal stenosis.
Degenerative spinal stenosis refers to cases of this condition that are caused by wear and tear on the spine. This is the most common type of spinal stenosis.
Spinal degeneration is a normal effect of aging. It occurs as the intervertebral discs and facet joints weaken from repeated strain over time. Factors including a sedentary lifestyle, poor posture, obesity, injuries, smoking, and other spinal disorders (such as scoliosis) can speed up the process of spinal degeneration.
Effects of aging that can contribute to the development of degenerative spinal stenosis include:
Leading a healthy lifestyle by exercising, eating a nutritious diet, and maintaining an optimal weight can help prevent spinal stenosis.
Options for spinal stenosis treatment include:
Various exercises can help with spinal stenosis by improving strength and mobility in the affected areas. You can perform these exercises at home to support your lumbar spinal stenosis recovery.
Examples of spinal stenosis exercises include:
This exercise engages the glute muscles, which support the pelvis and can help reduce the strain on the lumbar spine.
This simple exercise engages the transverse abdominis, which is a deep abdominal muscle that promotes proper spinal alignment and helps protect the lower spine.
This exercise stretches and helps relieve tension in the lower back muscles. It also flexes the spine, which relieves pain from spinal stenosis by temporarily creating more space in the spinal canal.
Physical therapy may improve symptoms of lumbar spinal stenosis by relieving pressure on the spinal cord. For lumbar spinal stenosis, physical therapy typically involves stretches for the lower back, legs, and hips, as well as strengthening exercises for the abdominal muscles, which support the lower spine. Your physical therapist may work with you on mobility exercises to improve your range of motion in the lower back.
Additionally, physical therapy may involve treatments that can help with pain, tension, and inflammation. These treatments include heat/cold therapy, electrostimulation, massage, etc.
Both over-the-counter and prescription medications may be used to reduce pain and inflammation from lumbar spinal stenosis. Talk to your doctor before starting a new medication for spinal stenosis symptoms in the lumbar spine.
In extreme cases, surgery for lumbar spinal stenosis may be recommended. Typically, doctors don’t recommend lumbar spinal stenosis surgery unless the patient has first undergone at least 6 months of conservative treatment.
For lumbar spinal stenosis, spinal decompression surgery is often performed. This type of surgical procedure involves removing portions of the vertebrae that are impinging on the roots of nerves emanating from the spine. By relieving this pressure, the procedure gives patients symptom relief and provides the spinal nerves with enough space to heal.
Laminectomy is the most common form of spinal decompression surgery for spinal stenosis of the lumbar region. In this procedure, the surgeon removes all or part of the lamina, which forms the ceiling of the spinal canal. Other types of spinal decompression surgery include foraminotomy and discectomy.
Following the spinal decompression procedure, spinal fusion back surgery has traditionally been performed to stabilize the spine. Spinal fusion involves placing bone graft material in between the affected vertebrae. Over time, the bone graft will cause the vertebrae to permanently fuse.
Unfortunately, this stabilization procedure eliminates the independent motion of the fused vertebrae and can contribute to the deterioration of adjacent vertebrae. Patients can lose a significant amount of motion in the lower back after spinal fusion.
Spinal fusion alternatives, such as non-fusion implants, can offer stability without limiting the patient’s mobility after spinal stenosis surgery. The TOPS™ System, for example, provides an alternative to spinal fusion that maintains the spine’s full range of motion. It’s been proven in clinical studies conducted worldwide to provide superior outcomes than spinal fusion following spinal decompression surgery.
Patients seeking surgical relief for an abnormal narrowing of the spine now have access to a wider range of treatment options than ever. Talk to your doctor about the best course of treatment for your needs.
Though you may not realize it, spinal decompression is an important topic for many people suffering from debilitating back pain. Spinal decompression refers to the process of relieving pressure on one or more pinched (or impinged) nerves in the spinal column. The pressure on such nerves can cause pain, restrict mobility, and a host of other physical problems.
A vast range of spinal conditions, including spinal stenosis, disc degeneration, bulging, herniated or slipped discs, and facet syndrome, can place pressure on nerves emanating from the spinal column. This may create the need for spinal decompression surgery.
This article will dive into the specifics of spinal decompression and how it could benefit your recovery from chronic back pain.
So, what is spinal decompression? It’s a treatment for various spinal conditions that can be performed both surgically and non-surgically.
Non-surgical spinal decompression utilizes mechanical, computer-controlled traction devices to reduce the pressure placed on nerves in specific portions of the spine. Inversion therapy, in which patients hang upside down, is another form of non-surgical spinal decompression. Certain spinal decompression exercises may also be effective for alleviating back and nerve pain.
For patients who don’t respond to non-invasive methods, spinal decompression surgery can provide dramatic symptom improvement. In this surgical procedure, portions of the bone or tissue of the spine that impinge on a nerve are cut away, relieving the pressure.
Historically, the spinal fusion procedure has been performed in conjunction with spinal decompression surgery. Fusion stabilizes the spine at the point where the decompression procedure was performed.
Unfortunately, spinal fusion, which fuses two (or more) vertebrae to enhance spinal stability, eliminates the independent motion of the fused vertebrae. This may accelerate the degeneration of adjacent vertebrae.
Today, the TOPS™ (Total Posterior Spine) System provides a spinal fusion alternative for patients who are considering spinal decompression surgery. In contrast to fusion, TOPS preserves the complete range of the spine’s natural motion and has been shown to provide better outcomes than fusion in global clinical studies.
A large nerve pathway extends through the middle of the spinal canal. When these nerves become compressed and irritated, whether due to an injury or age-related degeneration, you may experience lasting pain. With this in mind, patients undergo spinal decompression for relief from spinal nerve compression symptoms.
Non-surgical spinal decompression is performed as a conservative treatment option for persistent back pain. Whether caused by a condition like spinal stenosis or simply poor posture, back pain can benefit from non-invasive spinal decompression.
Surgical spinal decompression, on the other hand, is typically done only for severe spinal conditions. It’s generally only considered after the patient has undergone six to 12 months of non-surgical treatment without experiencing improvement.
Additionally, surgical spinal decompression is typically implemented for patients experiencing severe spinal nerve compression and who are at risk of permanent nerve damage.
Spinal decompression, both surgical and non-surgical, may be used to treat:
The tough outer shell of an intervertebral disc becomes weaker and thinner with age. Eventually, the disc may flatten and bulge out into the spinal canal.
A herniated or slipped disc goes one step beyond a bulging disc. When a disc becomes herniated, it means that the soft disc interior protrudes through a crack in the disc exterior.
Sciatica occurs when the sciatic nerve, which extends from the lower back through the backs of both legs, becomes irritated. This results in symptoms including burning, tingling, numbness, pain, and/or weakness along the path of the sciatic nerve.
Degenerative disc disease refers to back pain and other symptoms caused by a degenerated intervertebral disc. This degeneration typically occurs from age-related wear-and-tear.
A pinched or compressed spinal nerve causes symptoms like pain, tingling, numbness, and weakness.
Spinal stenosis occurs when the spinal canal gradually becomes narrower. This condition limits the amount of open space in the spinal canal, which can trigger spinal nerve compression.
Spondylolisthesis develops when one of the vertebrae in the spine shifts out of its regular position and settles on the bone directly beneath it. In some cases, the displaced vertebra compresses nearby nerves.
During non-surgical spinal decompression, the patient is positioned on a motorized device like a traction table. This device uses motorized traction to gently stretch the spine. This process alters the alignment of the spine, as well as the forces placing stress on the spine.
When non-surgical spinal decompression is successful, it removes pressure from the nerves and other spinal structures. It also increases the flow of oxygen, nutrients, and water to the spine, which promotes healing.
Although the goal of surgical spinal decompression is the same as its non-surgical counterpart, the process is completely different. For one, numerous techniques of surgical spinal decompression exist, namely laminectomy/laminotomy, foraminotomy/foraminectomy, and discectomy.
Chiropractors perform non-surgical spinal decompression therapy. Only a qualified, licensed spinal surgeon can perform spinal decompression surgery.
A spinal decompression chiropractor stretches and manipulates the spine to alleviate back and leg pain. This process is entirely non-invasive, making it a safe, low-risk choice for patients to consider.
Your chiropractor may also be able to recommend spinal decompression stretches. You can perform these stretches anywhere, at any time, making it possible to undergo spinal decompression at home. For example, reaching your arms above your head, interlacing your fingers, and trying to touch your palms to the ceiling is one stretch that can help decompress the spine.
Most patients who undergo non-surgical spinal decompression therapy from a professional chiropractor will experience symptom relief after four to six weeks. In this period, patients may undergo weekly spinal decompression sessions. Some patients may notice pain relief after just one session, while others will need more sessions to experience significant symptom improvement.
Surgical spinal decompression works differently. Patients will likely experience soreness and inflammation for a few days after the procedure. Post-operative pain will gradually improve, with most patients needing approximately four to six weeks to regain their mobility.
Spinal decompression surgery is commonly paired with spinal fusion. As aforementioned, the goal of fusion is to prevent spinal instability by permanently connecting the affected vertebrae. Spinal fusion significantly lengthens the recovery time for spinal decompression surgery, requiring up to a year for patients to make a full recovery.
Spinal decompression is typically considered necessary if:
If you’re a patient whose pinched spinal nerve is not responding to non-invasive decompression methods, make sure to discuss all of your surgical options with your physician.
Lower back pain has long been a prevalent health concern around the world. In 2017, the prevalence of lower back pain was estimated to be approximately 7.5% of the world’s population. This totals about 577 million people.
There are numerous causes of lower back pain, as well as countless treatments that can help relieve it. Lumbar spinal decompression is one treatment strategy for alleviating lower back pain caused by a pinched nerve.
This article will discuss lumbar spinal decompression, when it’s implemented, and what patients can expect from the procedure.
Imagine if the branches of a tree were as large at the top as they are at the bottom. Now, imagine that a heavy load is placed on the ends of the very highest branches. This would put an enormous amount of stress on the lower portion of the tree trunk.
This is comparable to what we experience as humans with our spinal columns. The human spinal column is like the trunk of a tree, but we’re as large on the top of the trunk as we are at the bottom. This puts a high amount of stress on the lower back, which is also called the lumbar region of the spine.
The strain of lifting objects and twisting the spine over the course of a lifetime is exacerbated by degenerative spinal changes that occur with age. So, it’s not surprising that most of the back problems that bring patients to spinal specialists are centered in the lower, or lumbar, region of the spine.
The stresses discussed above, along with disease and/or injury, can result in a host of spinal disorders. Bulging or herniated discs, spinal stenosis, and spondylolisthesis are among the most common.
A bulging disc is a spinal disorder that occurs when the exterior of an intervertebral disc weakens, typically from the natural aging process. This can cause the disc to bulge out into one side of the spinal canal.
A herniated disc is essentially one step further than a bulging disc. It occurs when the soft interior of the disc protrudes out through a crack in the weakened disc exterior.
Spinal stenosis can result from a bulging or herniated disc, as well as a range of other factors. It’s a spinal condition characterized by an abnormal narrowing of the spinal canal.
Reduced space in the spinal canal can place stress on the spinal nerves or the spinal cord. But, decompression for lumbar spinal stenosis can effectively alleviate this stress.
Spondylolisthesis is a condition that develops when one of the vertebrae is unstable and slips out of its regular position. The displaced vertebra settles on the vertebra beneath it.
These disorders can place unnatural pressure on the nerves that emanate from the spinal column. This may cause pain, restricted mobility, and other symptoms of a pinched nerve.
Spinal decompression is a method of easing pressure on impinged spinal nerves. It can be performed either non-surgically or surgically. Lumbar spine decompression simply refers to decompression procedures performed on the lower portion of the spine.
The surgical solution for a lumbar pinched nerve involves removing a small amount of tissue from vertebrae in the lumbar region. The surgeon will remove the tissue that’s impinging, or putting pressure, on a nerve. This process is referred to as lumbar spinal decompression surgery.
There are various types of lumbar decompression surgery that may be implemented for different spinal disorders. The most common forms of surgical lumbar decompression include:
Laminectomy and laminotomy are two surgical methods of lumbar decompression that involve the lamina. The lamina acts like the roof of the spinal canal and protects the spinal cord.
Laminoplasty is a procedure that involves making two cuts in the lamina so that it swings outward, like a door. After creating a hinge with the lamina of the affected vertebra, the spinal surgeon will position small bone wedges to keep the “door” from closing. Commonly referred to as open-door laminoplasty, this procedure can effectively alleviate pressure on the spinal nerves without removing the lamina.
In foraminotomy, the surgeon creates more space around the area where nerve roots exit the spinal canal. This area is known as the intervertebral foramen. It acts as a passageway, linking the spinal canal to the periphery.
By opening up the intervertebral foramen in foraminotomy, the spinal surgeon can alleviate pressure on the spinal nerves.
Discectomy is a spinal decompression procedure that involves removing damaged intervertebral disc tissue. The spinal surgeon may remove some or all of the damaged disc, depending on the patient’s needs.
Removing tissue in lumbar decompression surgery can lead to spinal instability. So, historically, spinal fusion back surgery has been performed in conjunction with lumbar decompression surgery to stabilize the spine.
In spinal fusion, the surgeon places bone graft material in between the affected vertebrae. As weeks and months pass after the procedure, the vertebrae will fuse, forming a singular bone. By completely preventing motion in this segment, fusion effectively prevents instability following spinal decompression surgery.
Unfortunately, lumbar decompression and fusion can have certain negative effects on the body, including:
The key downside of spinal fusion is that it prevents all motion in the fused segment. This eliminates the patient’s ability to flex, twist, and bend the spine normally. As a result, patients may no longer be able to partake in their favorite sports and activities after spinal fusion surgery.
The spinal segments that are adjacent to the fused vertebrae must undergo additional stress to compensate for the fusion. This can lead to a complication known as adjacent segment disease (ASD), with which the adjacent vertebrae deteriorate at a more rapid rate. ASD can lead to lower back pain, radiating pain, difficulty walking or standing, and neurological symptoms.
Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that preserves the spine’s natural full range of motion. This advanced spinal implant has been shown to provide better outcomes than fusion in clinical studies performed around the world.
The TOPS™ System provides an important additional treatment option for individuals with moderate to severe pinched nerve symptoms. It can provide a major improvement in lower back pain for patients who don’t respond to non-surgical lumbar spinal decompression therapy.
The recovery period for lumbar decompression surgery can vary depending on the exact procedure and whether or not spinal fusion is performed. However, patients can generally expect to wait four to six weeks before reaching their expected degree of mobility and returning to work.
Spinal fusion prolongs the recovery process for lumbar decompression surgery. It can take up to a year to fully recover from fusion. With this in mind, the TOPS™ System can significantly reduce the lumbar decompression surgery recovery time, allowing patients to return to physical activity much sooner.
Lumbar decompression surgery is an invasive procedure. So, as with any surgical procedure, it comes with certain risks.
With that said, lumbar decompression is widely performed and considered safe. Advancements in medical technology have even made minimally-invasive lumbar decompression surgery possible. This allows for greater safety and a lower risk of complications.
If you have symptoms of a pinched nerve, don’t hesitate to talk to your doctor about the complete scope of treatment options available to you.
Epidural injections of steroids have often been the treatment of choice for patients with a pinched nerve in the back whose symptoms did not respond to simple exercise, physical therapy, or other more conservative approaches. Steroid injections have also been offered to patients with spinal stenosis whose back pain was unrelieved by less invasive therapy. But the results of a new research study hint that injections of steroids for back pain may be less beneficial than believed. The study is small, but it still bears consideration, as the findings are statistically valid and underscore why healing is as much an art as a science.
The study of the efficacy of steroid injections for back pain examined more than 270 patients, aged 53 to 75 years old, culled from the ranks of a larger study of individuals with spinal health problems. The research subjects were followed for four years. Sixty-nine of these patients had epidural injections and 207 did not, but otherwise the patients’ symptoms were primarily the same in terms of severity, as measured by well-established scales used to measure pain in the leg and lower back. Using these scales, researchers found less improvement among those who had epidural injections than among patients who did not have injections.
Several caveats must be offered when considering the results of this research. First, as the authors readily acknowledge, factors that the researchers didn’t account for and couldn’t control may have affected or skewed the results. Nonetheless, we are seeing fresh thinking and new techniques improving outcomes for many spinal patients. For example, patients who elected to have spinal decompression surgery to relieve symptoms of pinched nerves typically opted for a spinal fusion back surgery in tandem, in order to stabilize the spine. Today, a growing number are opting for TOPSTM – the Total Posterior Solution – System, instead of spinal fusion. The TOPS system, unlike spinal fusion, preserves complete independent motion of the individual vertebrae. This is one more way that fresh thinking, and new technologies and procedures are transforming the care and treatment of back problems.
Spinal stenosis, an unnatural narrowing (or stenosis) of the spinal canal, is an all too common cause of back pain and restricted mobility, which results from pressure the narrowing column places on spinal nerves. For those who don’t respond to more conservative treatments, surgery may be recommended to correct spinal stenosis, and it’s important for such patients to prepare for the procedure properly. The preparations starts by ascertaining that back surgery is indeed called for.
Pain in your leg that is greater than the pain in your back caused by a pinched nerve (as measured by standard pain scales), is one indication that surgery is appropriate for a given case of spinal stenosis. Leg pain that does not decrease and interferes with your quality of life, and radiological scans confirming that the pain is likely due to nerve compression, are also indications that surgery may be beneficial.
Much of the advice on preparing for any back surgery applies to a spinal stenosis operation, as well. As in other back surgeries, you should stop smoking and, if overweight, shed excess pounds. Get your blood pressure down. Walk, or engage in other moderate activity that gets your muscles moving. This is important to speed your recovery process.
Check the medications you’re taking and discuss them with your physicians to ensure the medications will not interfere with your surgery or recovery. For example, blood thinners can interfere with blood clotting. Among women, birth control pills and hormone replacement therapy can also interfere with surgery.
Traditionally, spinal fusion back surgery has been performed in conjunction with spinal stenosis surgery to stabilize the spine at the site of the operation. A drawback of spinal fusion is that the procedure eliminates the independent motion of the fused vertebrae, and is also physically demanding. Now there is an alternative to spinal fusion following spinal stenosis surgery. The TOPSTM (Total Posterior Solution) System can be used instead of spinal fusion, and has better outcomes. Investigating whether this alternative procedure makes sense for you could be one of the best ways to prepare for your surgery for spinal stenosis.