Lumbar Spinal Stenosis Symptoms

Lumbar spinal stenosis is a prevalent condition affecting the lower portion of the spine. It’s usually triggered by age-related spinal degeneration and can cause significant lower back pain. Left untreated, lumbar spinal stenosis can cause disability and a reduced quality of life. 

Unfortunately, lumbar spinal stenosis affects many adults at some point in their later years. But, with the proper treatment, you can overcome spinal stenosis symptoms and gain a new lease on life.

In this article, we’ll review the types, causes, and symptoms of lumbar spinal stenosis, along with the latest treatment options to fix it. 

Table of Contents

What Are the Main Types of Spinal Stenosis?

The main types of spinal stenosis are central canal stenosis, lateral recess stenosis, and foraminal stenosis. 

Central Canal Stenosis

Central canal spinal stenosis occurs in the central spinal canal. The central spinal canal protects the spinal cord, so central canal stenosis poses the risk of spinal cord compression. 

Typically, central canal spinal stenosis involves thickened ligaments and bone overgrowth (i.e. bone spurs) that constrict the spinal canal. It may affect the upper, middle, or lower portion of the spine, though lumbar central canal stenosis is the most common. 

Lateral Recess Stenosis

Lateral recess spinal stenosis involves the narrowing of the lateral recess, the area near the sides of the spinal canal. Also known as Lee’s entrance, the lateral recess is near the spinal nerve root and acts as a passway for nerves. 

With this form of spinal stenosis, Lee’s entrance becomes smaller and smaller, limiting the space for the nerves. As a result, the nerves may become compressed by bone tissue and impair pressure on intervertebral discs. 

Foraminal Stenosis

Foraminal stenosis occurs when the intervertebral foramen narrows. The foramen are bony passageways through which nerves enter and exit the spine. They facilitate the delivery of nerve signals from the brain to the rest of the body. 

With foraminal stenosis, bone tissue may compress spinal nerve roots, leading to back pain and neurological symptoms, like numbness, weakness, and tingling. 

What Are Conditions That Could Cause Spinal Stenosis?

Conditions that could cause spinal stenosis include:

Spinal Stenosis from Degenerative Spondylolisthesis

Degenerative spondylolisthesis occurs when age-related changes to the spine cause a vertebra to slip out of its normal position. The affected vertebra falls onto the vertebra beneath it and may reduce the space in the spinal canal, causing spinal stenosis. The vertebra may also compress nearby nerves, leading to neurological symptoms. 

Spinal Stenosis from Bone Spurs

Bone spurs are a common complication of osteoarthritis, a degenerative condition involving the breakdown of cartilage in the joints. As cartilage deteriorates, it increases friction and inflammation within the joints. Your body may gradually produce extra bone tissue – bone spurs –  in response to this friction. 

As small lumps of bone tissue, bone spurs take up space in the spinal canal, potentially causing symptoms of spinal stenosis. 

Spinal Stenosis from a Herniated Disc

A herniated disc is an intervertebral disc that becomes damaged, usually due to age-related spinal degeneration. Over time, the discs that cushion the spine become thinner, drier, and weaker. As a result, cracks can form in the tough disc exterior, and the jelly-like interior may push through it. 

The herniated disc (also known as a bulging or ruptured disc) can protrude into the open space in the spinal canal, causing spinal stenosis. 

Spinal Stenosis from Fractures

Vertebral fractures can result from weakened bone tissue (due to osteoarthritis) or a sudden trauma to the spine (like a fall). The broken bone can limit the space in the spinal canal, causing spinal stenosis. 

Spinal Stenosis from Cysts or Tumors

Spinal cysts or tumors take up space in the spinal canal and may cause spinal stenosis symptoms. In these cases, the cyst or tumor can typically be surgically removed to alleviate symptoms, protect neurological function, and stabilize the spine. 

What Are the Worsening Symptoms of Spinal Stenosis?

The worsening symptoms of lumbar spinal stenosis include back pain and numbness, tingling, and or weakness that radiates into the extremities. 

Back Pain from Spinal Stenosis

Back pain from spinal stenosis occurs in the area of the back that’s affected by a narrowed spinal canal. This condition most often affects the lumbar spine, causing lower back pain. 

Lower back pain is a primary spinal stenosis symptom that tends to get worse over time. The pain may feel like a dull ache, tenderness, or burning in the back. Additionally, lower back pain from spinal stenosis can come and go, with flare-ups from certain activities and motions, like excessive back extension.

Neurological Symptoms from Spinal Stenosis

Neurological spinal stenosis symptoms can also worsen over time. These symptoms result from spinal nerve compression and tend to include tingling, weakness, and numbness. If the compressed nerve is located in the lumbar spine, these symptoms may radiate into the buttocks, legs, and feet. 

Professional medical treatment for spinal stenosis can help prevent worsening symptoms and preserve your mobility. The sooner you seek treatment for this spinal condition, the more successful the treatment will be. Early intervention also helps prevent the need for surgery to treat spinal stenosis. 

Can L4 L5 Stenosis Cause Paralysis?

L4 L5 stenosis can cause paralysis if left untreated for a prolonged period. 

Signs of nerve compression in the L4 L5 segment of the spine include weakness, tingling, and/or numbness that radiate into the lower extremities. With proper treatment, it’s possible to lessen the pressure on the spinal nerves and improve these symptoms. However, if the nerve compression is left untreated for an extended period and becomes severe, it can cause partial or full leg paralysis. 

If you experience any of the following warning signs with L4 L5 spinal stenosis, seek emergency medical care to prevent permanent nerve damage and paralysis:

  • Loss of bladder or bowel control (incontinence)
  • Difficulty walking and/or balancing
  • Lost or reduced sensation in the buttocks, inner thighs, backs of legs, feet, or heels
  • Sexual dysfunction

How Do You Fix Lumbar Spinal Stenosis?

You can fix lumbar spinal stenosis with surgical procedures to decompress the spinal nerves. 

Unfortunately, non-surgical treatments can’t open the spinal canal back up after it’s been affected by spinal stenosis. Only surgery can achieve this feat. However, non-invasive methods can help resolve spinal stenosis symptoms in many cases. 

Non-invasive treatments for spinal stenosis include:

  • Physical therapy
  • Chiropractic care
  • Pain medications
  • Lifestyle adjustments (such as exercising, quitting smoking, and eating a nutrient-dense diet)
  • Acupuncture
  • Massage therapy

Surgery to Fix Spinal Stenosis

Surgery for spinal stenosis typically involves spinal decompression. This type of procedure resolves the nerve compression to alleviate lower back pain and neurological symptoms. Examples of these procedures include laminectomy, foraminotomy, and discectomy. 

Spinal decompression can destabilize the spine. To offset this risk, decompression procedures are conventionally performed with spinal fusion, a process of fusing two or more vertebrae to prevent instability. 

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