Severe Spinal Stenosis L4-L5 Symptoms

Spinal stenosis, a condition characterized by a narrowing spinal canal, often affects the lumbar spine. Lumbar spinal stenosis affects over 200,000 people in the U.S., making it a significant cause of pain and disability. The L4-L5 segment is often the site of spinal stenosis, as it supports the weight of the rest of the spine. 

Severe spinal stenosis L4-L5 can trigger a range of symptoms, including chronic lower back pain, tingling, numbness, and muscle weakness. In this article, we’ll dive deeper into these symptoms and available treatments to resolve them.

Table of Contents

What Are the Symptoms of L4-L5 Nerve Damage?

The symptoms of L4-L5 nerve damage are:

  • Lower back pain
  • Pain that radiates into the lower extremities
  • Tingling, numbness, and the feeling of “pins and needles” that radiate into the lower extremities
  • Muscle spasms
  • Increased sensitivity in the lower back

What Are the Symptoms of Severe L4-L5 Spinal Stenosis?

We go into more detail on this topic in our article: symptoms of severe L4-L5 spinal stenosis

  • Severe lower back pain 
  • Burning or radiating pain that moves from the lower back into the buttocks and legs
  • Numbness and muscle weakness in the legs and feet
  • Calf cramping
  • Inability to walk without taking frequent breaks

Possible Complications of Severe L4-L5 Spinal Stenosis

Severe L4-L5 spinal stenosis can lead to serious complications if left untreated. These may include:

  • Numbness and loss of sensation
  • Decreased leg strength
  • Loss of bowel or bladder control (incontinence)
  • Difficulty with balance
  • Higher risk of falls
  • Sexual dysfunction

Without medical care, L4-L5 spinal stenosis can lead to permanent nerve damage and even paralysis. This makes it crucial to see a physician soon after the onset of spinal stenosis symptoms.  

How Does Spinal Stenosis Cause L4-L5 Nerve Damage?

With lumbar spinal stenosis, the spinal canal in the lower back becomes narrower. As space in the canal decreases, tissue (such as damaged disc material, thickened ligaments, or bone) may press on the spinal nerves. This can cause inflammation and damage over time. 

Is Spinal Stenosis L4-L5 Serious?

Spinal Stenosis L4-L5-Symptoms

Spinal stenosis L4-L5 is serious because it can lead to chronic pain and lost mobility if left untreated.

In the early stages, spinal stenosis symptoms often don’t feel serious. Some patients experience only mild back pain. However, visiting a doctor for a diagnosis as soon as possible will slow the condition’s progression, reducing your risk of serious complications. 

As a condition that affects the spinal nerves, L4-L5 spinal stenosis must be treated promptly to prevent lasting damage. Patients need to take this condition seriously, not only to prevent nerve damage, but also to reduce the need for surgery. Most mild cases of lumbar spinal stenosis can be resolved without surgery with prompt care. 

Can Spinal Stenosis in L4 L5 Cause Paralysis?

Spinal stenosis in the L4 L5 segment can cause paralysis in severe cases. 

Paralysis can occur if the narrowing spinal canal presses on the spinal cord. The spinal cord is vital to the body’s ability to transmit motor commands between the brain and body. It also gives the body physical reflexes and relays sensory information to the brain.

Pressure from spinal stenosis can eventually damage the spinal cord. This may lead to full or partial leg paralysis, incontinence, and balance problems.

How Common is Paralysis from Lumbar Spinal Stenosis?

Paralysis from lumbar spinal stenosis is very rare. Treatment can prevent stenosis from progressing into this severe complication. 

How Do You Treat L4-L5 Spinal Stenosis?

You can treat L4-L5 spinal stenosis with conservative treatments including medications, steroid injections, physical therapy, and lifestyle changes. Severe L4-L5 stenosis often must be treated with surgery. 

Non-Surgical L4-L5 Spinal Stenosis Treatments

While non-surgical treatments can’t reverse the narrowing of the spinal canal, they can reduce inflammation, lessen the impact on spinal nerves, and reduce pain. 

The most common non-surgical treatments for L4-L5 spinal stenosis include:

  • Anti-inflammatory medications can help with spinal stenosis pain and bring down swelling. Your physician may recommend over-the-counter medications (like acetaminophen) or, in more severe cases, provide prescription-strength drugs. Keep in mind that:
    • Medications alone usually can’t resolve spinal stenosis. It may be combined with other methods, like physical therapy, to provide lasting relief. 
    • Medications can cause side effects and interact with other drugs. Talk to your doctor about all the medications you’re taking (including supplements) before starting treatment. 
  • Steroid injections lessen inflammation in the spinal canal. They’re administered into the epidural space, which is the area surrounding the spinal nerves. Keep in mind that:
    • Undergoing more than three to four steroid injections per year can cause tissue atrophy. 
  • Physical therapy for L4-L5 spinal stenosis may involve strengthening exercises, flexibility exercises, stabilization methods, massage, and joint mobilization. Some physical therapists also recommend heat/ice therapy and acupuncture. PT can:
    • Reduce stress on the spinal nerves by strengthening the muscles that support the spine
    • Alleviate muscle tension and improve the spine’s range of motion
    • Improve spinal alignment to prevent excessive impact on the L4-L5 segment
  • Lifestyle changes for L4-L5 spinal stenosis may include:
    • Complete gentle physical activity to boost blood flow and maintain mobility, like swimming, walking, and aerobics
    • Lose excess weight to reduce the impact on the L4-L5 segment
    • Follow an anti-inflammatory diet including vegetables, fruits, whole grains, olive oil, and spices like turmeric
    • Improve your posture, especially while sitting and standing 

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Surgery for Severe L4-L5 Spinal Stenosis

Severe L4-L5 spinal stenosis often requires surgery. Surgery can resolve nerve compression and create more space in the spinal canal. 

Surgery for severe L4-L5 spinal stenosis usually involves laminectomy. In this procedure, the surgeon removes some or all of the lamina (the bone covering the back of the spinal canal). This alleviates pressure on the spinal nerves and the spinal cord. 

Spinal fusion usually follows laminectomy to stabilize the spine. However, with concerns including reduced range of motion and adjacent segment degeneration, alternatives are gaining popularity. 
One alternative, the TOPS System, has been deemed superior to fusion by the FDA for lumbar spinal stenosis and spondylolisthesis. This dynamic implant stabilizes the spine and re-establishes a controlled range of motion. Contact a specialist in your area to learn more