Lumbar Spinal-Lateral Recess Stenosis

Lumbar spinal-lateral recess stenosis is a type of spinal stenosis involving the narrowing of the lateral recess. This is the area on the sides of the vertebrae, through which the nerve roots exit the central spinal canal. With this spinal condition, you may struggle with chronic back pain and neurological symptoms, leading to disability. 

Thankfully, with early intervention, lumbar spinal-lateral recess stenosis can often be managed successfully, before symptoms become severe. Read on to learn more!

Symptoms of Lumbar Spinal-Lateral Recess Stenosis

Symptoms of lumbar spinal-lateral recess stenosis may include:

  • Lower back pain
  • Pain that radiates through the buttocks to the lower extremities
  • Lower back cramping
  • Numbness and tingling in the lower extremities
  • Weakness in the lower extremities and “foot drop”
  • Difficulty walking and standing for prolonged periods

Lower Back Pain and Cramping from Lumbar Lateral Recess Stenosis

Lower back pain from lumbar lateral recess stenosis may be described as dull, aching, sharp, or burning. This pain results from nerve root irritation and compression in the lateral recess. Depending on the area that the compressed nerve root supplies, this pain may radiate into the buttocks and legs. 

Lateral recess stenosis can also lead to lower back cramping. When the narrowing lateral recess presses on spinal nerve roots, it can alter the signals they send to your muscles, causing uncomfortable cramps or spasms. 

Foot Drop from Lumbar Lateral Recess Stenosis

Foot drop is the term used for weakness that makes it difficult to lift the front part of the foot, causing the foot to slap onto the ground when you walk. It’s a neurological symptom that can result from lumbar nerve compression. With foot drop, your foot may drag or your toes may scuff the ground when you walk. 

What Causes Lateral Recess Stenosis?

Lateral recess stenosis can be caused by age-related spinal changes, degeneration, spinal injuries, or genetic conditions like scoliosis. 

Age-Related Spinal Changes

The spine naturally changes with age. Ligaments thicken and spinal discs get thinner, drier, and weaker. These changes can take up space in the lateral recess, leading to spinal stenosis. 

Spinal Degeneration

Spinal degeneration from conditions like osteoarthritis, bone spurs, and degenerative disc disease can trigger lateral recess stenosis. 

  • Osteoarthritis, or “wear and tear arthritis”, is a joint condition that can affect the facet joints of the spine. It breaks down the cartilage, which is the shock-absorbing tissue that protects your joints from damage.
    • Bone spurs are a common complication of osteoarthritis. They’re small lumps of bone that form in response to friction in the joints. When bone spurs form in the spine, they can lead to lateral recess narrowing. 
  • Degenerative disc disease is a chronic condition involving damage to the protective discs in your spine. The discs are located in between the vertebrae and absorb impact with various movements. They can break down over time with age and overuse, increasing your risk of a slipped or ruptured disc. Damaged disc tissue can protrude into the lateral recess, causing stenosis symptoms. 

Genetic Conditions

Genetic conditions like scoliosis and achondroplasia can cause lateral recess stenosis earlier in life. While most lateral recess stenosis cases occur after age 50, genetic factors can cause symptoms in childhood, adolescence, or early adulthood. 

  • Scoliosis is a deformity involving a sideways spinal curve. It’s usually diagnosed in a patient’s teenage years and can be managed with physical therapy, bracing, and (in severe cases) surgery. Scoliosis places imbalanced forces on the spine that can rapidly accelerate spinal degeneration, potentially causing spinal stenosis relatively early in life. 
  • Achondroplasia is a genetic bone growth disorder and the most common cause of short-limbed dwarfism. It compromises the function of the fibroblast growth factor receptor, which slows growth plate cartilage development. An estimated one-third of achondroplasia patients develop spinal stenosis that requires surgery, although this usually occurs after age 15. 

While scoliosis is relatively common, affecting around seven million people in the U.S., achondroplasia is rare, appearing in an estimated one in every 40,000 births. 

Is Lateral Recess Stenosis a Disability?

Lateral recess stenosis can be considered a disability if it considerably compromises your ability to function at work or undermines your employability by forcing you to take time off of work.

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Why is this distinction important? In the United States, disabled people can qualify for Social Security Disability benefits, including Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). These government benefits, administered by the Social Security Administration, provide monthly payments to people with a disability that limits or eliminates their ability to work. 

To be considered a disability under Social Security’s rules, the following statements must apply to your condition:

  • You can’t work at the substantial gainful activity level because of your medical condition. “Substantial gainful activity” means that you earn more than a specified amount and engage in productive work. 
  • Your medical condition has made you unable to complete work you previously did and unable to transition to other work. 
  • Your medical condition has lasted or is expected to last for at least 12 consecutive months. 

Some, but not all, cases of lateral recess stenosis meet the criteria to be considered a disability by Social Security. Advanced cases that cause chronic, debilitating back pain that makes you unable to work generally qualify. You can contact your local Social Security office, an attorney, or a Social Security advocate for assistance with Social Security benefits for lateral recess stenosis. 

Treatment Options for Lumbar Spinal-Lateral Recess Stenosis

Treatment options for lumbar spinal-lateral recess stenosis include physical therapy, medications, lifestyle adjustments, and surgery (for severe cases). 

Physical Therapy for Lumbar Spinal-Lateral Recess Stenosis

Physical therapy is often the treatment that doctors initially recommend for lateral recess stenosis. It’s non-invasive and can provide sustainable pain relief by addressing imbalances and poor movement patterns. PTs can also improve spinal support through targeted muscle-strengthening exercises. 

Some providers compound the benefits of traditional PT with alternative remedies, like massage, acupuncture, dry needling, and electrical stimulation to further reduce your pain levels. 

Medications for Lumbar Spinal-Lateral Recess Stenosis

Medications, including oral painkillers and spinal injections, can be implemented for lumbar spinal-lateral recess stenosis. The most common oral medications for stenosis are NSAIDs, either over-the-counter or prescription, because they simultaneously reduce pain and calm inflammation. However, NSAIDs shouldn’t be taken long-term due to an elevated risk of gastrointestinal, kidney, liver, and heart issues. 

Spinal injections, such as epidural steroid injections, can help with spinal-lateral recess stenosis by tamping down the immune response in the affected area. This can provide relief from pain and inflammation, although it doesn’t address the underlying cause of the disease. 

Lifestyle Adjustments for Lumbar Spinal-Lateral Recess Stenosis

The following lifestyle adjustments can help treat lumbar spinal-lateral recess stenosis by reducing impact on the spine and supporting the body’s healing process:

  • Adopt a low-impact exercise routine
  • Reach and maintain a healthy weight
  • Practice good posture
  • Eat a balanced, nutritious diet
  • Quit smoking
  • Prioritize sleep
  • Wear supportive footwear

Surgery for Lumbar Spinal-Lateral Recess Stenosis

Lumbar spinal-lateral recess stenosis typically only requires surgery when conservative methods fail after several months. While laminectomy with fusion was previously regarded as the best surgical treatment for spinal stenosis, innovations like the TOPS System are negating the need for fusion – and the complications that it poses. 

Contact a participating physician in your area to learn more about the benefits of the TOPS System as a spinal fusion alternative.