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What Is the Best Treatment for Spinal Stenosis?
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The best treatment for spinal stenosis can range from patient to patient. Thankfully, many patients with spinal stenosis achieve symptom relief with non-surgical treatments, like physical therapy and lifestyle adjustments. But, when these therapies aren’t sufficient, surgery may be needed to fully resolve spinal stenosis.
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This article will explore the best treatment option to cure spinal stenosis in patients who don’t respond to non-invasive treatments.
An Overview of Spinal Stenosis
Spinal stenosis is a condition characterized by limited space in the spinal canal. The patient may either be born with a narrow backbone, or it may narrow over time (most commonly due to age-related degeneration).
In its early phases, spinal stenosis may not trigger symptoms. However, as the condition progresses and the spinal canal narrows, spinal nerves can become compressed. Nerve impingement from spinal stenosis can lead to:
- Chronic back pain
- Numbness
- Tingling
- Weakness
- Pain that radiates into the extremities (a leg or foot)
- Difficulty walking, especially for prolonged periods
In the late stages of spinal stenosis, patients may experience more severe neurological symptoms, such as bladder and/or bowel dysfunction. Problems with sexual function may also occur in patients with severe spinal stenosis.
What Happens if You Let Spinal Stenosis Go Untreated?
If you let spinal stenosis go untreated, your symptoms will worsen over time and eventually impact your quality of life. Left untreated, this spinal condition leads to increased nerve compression and irritation. Eventually, failing to receive professional treatment for spinal stenosis can lead to permanent spinal cord damage.
What Is the Best Treatment for Spinal Stenosis of the Lower Back?
In many cases, the best treatment for spinal stenosis of the lower back is decompressive laminectomy. This form of spinal decompression involves removing all or some of the lamina to create more space in the spinal canal. Given that spinal stenosis is characterized by the narrowing of the spinal canal, this procedure can resolve stenosis symptoms.
What is a Laminectomy?
A laminectomy is a type of spinal decompression surgery. During the procedure, a surgeon removes the smallest possible portion of the lamina from the affected spinal segment. The lamina is a piece of bone that covers the posterior side of the backbone.
According to a study published in Surgical Neurology International, lumbar laminectomy is one of the most commonly performed lumbar procedures for spinal stenosis. It’s been a prevalent form of spinal surgery for multiple decades, with an average of 34 laminectomy discharges per 100,000 adults annually from 1998 to 2008.
What Is the Difference Between a Laminectomy and a Decompression?
The difference between a laminectomy and a decompression is that laminectomy is a specific procedure, while decompression is a treatment category. Many different procedures fall under the decompression category, including laminectomy.
Other forms of decompression surgery include:
- Laminotomy
Laminotomy involves removing only a part of the lamina, while laminectomy involves removing all (or almost all) of the lamina.
- Discectomy
Discectomy, as the name suggests, involves removing some or all of an intervertebral disc. This decompression procedure is mainly done for patients with a herniated, slipped, or bulging disc.
- Foraminotomy
During a foraminotomy, the surgeon creates more space around one of the bones in the spinal canal (known as the foramen). This area creates the opening through which nerve roots exit the spinal canal. By enlarging it, your surgeon can resolve nerve root impingement.
Decompression can also refer to non-surgical spinal treatments. Many chiropractors perform non-surgical spinal decompression, which typically involves motorized traction therapy. During this treatment, the patient lies on a decompression table, which uses medical technology to realign the spinal structures.
How Is Decompression Laminectomy Done?
Decompression laminectomy is done in the following steps:
- Administer anesthesia.
A laminectomy is performed while the patient is fully asleep. So, to start, the patient is given general anesthesia. Once the patient has fallen asleep, the incision site is cleaned and prepped.
If spinal fusion will be performed with decompression laminectomy, the surgeon may prep the hip area to acquire a bone graft. However, a donor bone graft may also be used.
- Make an incision and access the spine.
Next, the surgeon will make an incision to access the spine. The conventional approach is a posterior incision, which is made over the back. With this approach, the back muscles must be moved to the side so that the surgeon can reach the spinal canal.
- Remove the lamina with specialized tools for each affected vertebra.
With complete access to the spine, the surgeon can remove the lamina. X-ray technology may be used to confirm the affected vertebra(e). Special tools, such as bone-biting tools or drills, are then used to extract the lamina, and the process is repeated for each affected vertebra.
At this point, the surgeon may also extract bone spurs and/or thickened spinal ligaments to fully resolve the patient’s spinal stenosis symptoms.
- Complete spinal fusion, if needed.
Conventionally, surgeons perform spinal fusion with a laminectomy to reduce the risk of instability. Fusion, which would be done between steps three and four listed above, involves positioning bone graft material in between the targeted vertebrae. This graft causes the vertebrae to slowly fuse.
Today, many patients want to avoid spinal fusion due to the associated risks. These risks include lost mobility and adjacent disc degeneration. Non-fusion spinal implants can be used as an alternative to reliably stabilize the spine without these complications.
- Suture the incisions closed.
To finish the decompression laminectomy procedure, the surgeon will close the skin and muscle incisions with staples and/or sutures. The patient is then transferred to a recovery area in the hospital, with comprehensive monitoring. Patients are typically released from the hospital in one to two days after decompression laminectomy (or three to four days if spinal fusion is done).
What Is L4 L5 Decompression Surgery?
L4 L5 decompression surgery is a form of spinal surgery that’s done on the L4-L5 segment of the lumbar spine. It’s performed as a treatment for nerve compression in the lumbar spine, which can be triggered by spinal stenosis, spondylolisthesis, herniated disc, and related conditions.
The L4 L5 level is the most commonly affected and surgically treated spinal level for lumbar spinal stenosis. The lumbar spine is generally more susceptible to spinal stenosis because it has greater mobility and undergoes more strain than the rest of the spine.
Decompression Laminectomy With the TOPS System
Decompression laminectomy with the TOPS System can cure spinal stenosis and eliminate the need for spinal fusion to stabilize the spine. As a mechanical implant device intended to be used in the L2 and L5 segments, the TOPS System is an ideal option for lumbar spinal stenosis patients.
The TOPS System replaces the tissues removed during decompressive laminectomy. It moves in all directions, allowing the patient a complete yet controlled range of spinal mobility. As a result, patients can comfortably flex, bend, walk, twist, and partake in various activities after laminectomy with TOPS.
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As an alternative to spinal fusion with decompression laminectomy, the TOPS System is an advanced treatment option for patients with lumbar spinal stenosis. Reach out to a specialist in your area for more information.
Spinal Stenosis: Self-Care Rules
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If you’ve been diagnosed with spinal stenosis, self-care should be prioritized as part of your recovery. While it’s crucial to visit a physician for a treatment plan, much of the healing process will rely on your own recovery efforts.
Self-care for spinal stenosis involves paying close attention to your symptoms, following your physician’s recommendations, and working to improve your health. Read on to learn more about our spinal stenosis self-care tips.
How Do You Stop Stenosis From Progressing?
To stop stenosis from progressing, it’s crucial to follow all of your physician’s recommendations and treatment suggestions. For most patients, these recommendations include:
- Maintaining good posture
Maintaining good posture is an excellent self-care strategy for spinal stenosis. Proper posture keeps the spine in alignment, which reduces the strain on the spinal structures. It can also help lessen nerve compression, which is a key issue for patients with spinal stenosis.
- Avoiding high-impact activities
High-impact activities like running, weightlifting, and contact sports, as well as activities that involve excessive spinal extension, can worsen spinal stenosis. Avoiding these activities can help prevent further injury to the spine.
- Practicing healthy body mechanics
Similar to good posture, proper body mechanics help minimize the impact on the spine with day-to-day motion. With healthy body mechanics, the spine is in a neutral position when you stand, walk, and exercise.
- Staying active
Although it’s important to avoid high-impact physical activity with spinal stenosis, don’t write off exercise altogether. Staying active helps with the spinal stenosis healing process by promoting circulation, maintaining muscle strength, and preventing loss of mobility.
- Attending physical therapy
Physical therapy is considered a crucial component of spinal stenosis treatment. Typically, physical therapists recommend a personalized set of exercises to strengthen the abdominal muscles, as well as stretches to improve mobility. Your PT may also recommend passive therapies, such as electrical stimulation, massage therapy, and acupuncture.
- Taking breaks from sitting
If you work at a desk, you likely spend most of your day sitting down. Unfortunately, prolonged periods of sitting can be damaging to the spinal discs and back muscles.
To care for your spine, try the “20-8-2” rule. This guideline recommends that people sit for 20 minutes, stand for eight minutes, and move around for two minutes. Then, repeat.
While this rule will likely need to be adjusted to fit your needs, it’s a great place to start for spinal stenosis patients.
- Prioritizing sleep
If you’re suffering from spinal stenosis or another spinal disorder, high-quality sleep is crucial. The deep stages of sleep increase circulation to the muscles, promote stress relief, and help reduce inflammation.
Unfortunately, back pain from spinal stenosis can make it difficult to fall asleep at night. Many people find that the best sleep position for spinal stenosis is the fetal position. Additionally, investing in a top-caliber mattress, such as a latex or memory foam mattress, may help you fall asleep with spinal stenosis pain.
How Can I Help Myself With Spinal Stenosis?
To help yourself with spinal stenosis, follow the tips provided above to stop the condition’s progression. These tips, including staying active, improving your posture, and preventing activities that stress the spine will help your body heal from spinal stenosis. Additionally, curbing the progression of this spinal condition may help you avoid invasive treatments in the future.
Does Lying Down Help Spinal Stenosis?
Lying down may help reduce spinal stenosis symptoms in some patients. Most patients find that the best sleeping position for spinal stenosis is lying on the side of the body with the knees curled towards the chest in a fetal position.
Though lying down can lessen spinal stenosis pain, it’s crucial to avoid staying in one position, whether it be lying down, sitting, or standing, for too long. Except for when you’re sleeping, of course, remaining in one position for an extended period can lead to muscle tension and increased pain.
Is a Heating Pad Good for Spinal Stenosis?
A heating pad is good for spinal stenosis, especially if you’re experiencing muscle tension and tightness from the condition. Heat therapy promotes muscle relaxation and boosts circulation to the area. Circulation improves the flow of healing nutrients and oxygen to the injured spinal tissue, which promotes healing.
What is The Best Vitamin For Spinal Stenosis?
The best vitamins for spinal stenosis include vitamin B12, vitamin B9, vitamin C, vitamin D, magnesium, and omega-3 fatty acids. Vitamin supplementation can be used as part of your spinal stenosis self-care strategy, but check with your physician before starting any new supplement.
- Vitamin B12
Vitamin B12 helps the body’s nervous system function properly. This makes it a valuable supplement for anyone suffering from neurological symptoms, including weakness, tingling, and numbness that can be caused by spinal stenosis.
In a study published in the European Spine Journal, 72% of patients with spinal disorders reported improved symptoms after vitamin B12 supplementation.
- Vitamin B9
Vitamin B9 (also known as folate or folic acid) is another B vitamin. As with all B vitamins, folate promotes a healthy nervous system and helps the body turn carbohydrates into glucose for energy.
In a 2010 study funded by the NIH, researchers discovered that folate promoted healing in damaged spinal cord tissue in rats. These results indicate that folate supplementation may assist the healing process in patients with nerve-related injuries, such as nerve impingement caused by spinal stenosis.
- Vitamin C
Vitamin C plays a few critical roles in healing and recovery. For one, the body needs vitamin C to produce specific neurotransmitters, as well as collagen and L-carnitine. It’s also a key part of connective tissue, which is essential for wound healing.
Additionally, with powerful antioxidant properties, vitamin C can help fight free radical damage and cell death. This can be especially helpful for patients who are recovering from spinal stenosis surgery.
- Vitamin D
Osteoporosis is a key risk factor for spinal stenosis and other spinal injuries. Vitamin D can help ward off osteoporosis because it helps the body absorb calcium.
Sun exposure is one of the best methods of vitamin D supplementation. But, people who don’t consistently spend time in the sun can consider supplements or foods that are rich in vitamin D, such as egg yolks and fatty fish.
- Magnesium
Magnesium is an essential nutrient that plays several different roles in the body. It supports muscle function, nerve function, and energy production. Magnesium has also been found to provide neuroprotective benefits, suggesting that it may help prevent nerve damage in spinal stenosis patients.
- Omega-3 Fatty Acids
A specific omega-3 fatty acid known as docosahexaenoic acid, or DHA, can be a helpful supplement for spinal stenosis patients. As the brain’s main fatty acid, DHT is crucial for central nervous system function and helps regulate cell membrane receptor activity.
Additionally, a 2019 study found that omega-3 fatty acid supplementation may help protect against the progression of spinal disc degeneration. So, omega-3 fatty acid supplements may help patients with degenerative spinal stenosis avoid further damage to the spine.
If at-home therapies fail to improve your spinal stenosis symptoms, visit a specialist in your area to learn about the available treatment options, such as the TOPS System from Premia Spine.
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Is Spinal Stenosis Hereditary?
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With a family history of any medical condition, it’s natural to worry that you’ll eventually develop the condition. This goes for spinal conditions, including spinal stenosis, which affects an estimated 250,000 to 500,00 residents of the United States.
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But, is spinal stenosis hereditary? Can you inherit it from your parents? In this article, we’ll address these common questions to resolve concerns surrounding your risk of developing spinal stenosis.
Does Everyone Get Spinal Stenosis With Age?
Almost everyone will get spinal stenosis with age. This is because it tends to develop as a result of the natural effects of aging on the spine. However, this doesn’t mean that everyone will require spinal surgery at some point.
Spinal stenosis refers to the narrowing of the spinal canal. For many patients, this process leads to nerve compression, which triggers pain and neurological symptoms. However, if the narrowed spinal canal doesn’t cause nerve impingement, the patient may be asymptomatic.
How Does The Spine Change With Age?
The spine undergoes a variety of changes during the aging process, including:
Cartilage Degeneration
For one, the cartilage that protects the facet joints wears down over time. When this occurs, the bones rub against one another, leading to pain and inflammation.
As the cartilage degenerates with age, patients may develop bone spurs. Bone spurs are the body’s response to friction between bones, and they can take up space within the spinal canal, leading to spinal stenosis.
Disc Degeneration
Another effect of aging on the spine is disc degeneration. A cushion-like disc is located between each vertebra of the spine. This disc absorbs impact to prevent damage to the spinal structures.
Unfortunately, the aging process causes the intervertebral discs to wear down, becoming thinner and drier. Eventually, this may cause the disc to bulge, herniate, or rupture. A damaged intervertebral disc can extend into the spinal canal and cause spinal stenosis.
Thickened Ligaments
Ligaments are coarse bands of tissue that connect bone to bone. The ligaments of the spine work with tendons and muscles to keep the spine stable.
With age, the ligaments of the spine can become thicker, especially in patients with arthritis. Thickened spinal ligaments may bulge into the spinal canal and cause spinal stenosis.
Who is Prone To Spinal Stenosis?
Various factors may make certain people more prone to spinal stenosis than others. These factors include:
- Age
As discussed in the previous section, the natural aging process often leads to spinal stenosis. So, people over the age of 50 are more prone to spinal stenosis than younger individuals.
- Gender
Women are more prone to spinal stenosis than men. Though the exact reasons for this risk factor are uncertain, experts think it may be linked to pregnancy, structural pelvic differences, and female hormone levels.
- Genetic factors
Some people are born with a narrower spinal canal than others. A naturally narrow spinal canal makes you more likely to develop spinal stenosis, especially when it’s combined with other risk factors.
- Other spinal conditions
Patients with a preexisting spinal condition, such as scoliosis or a spinal injury, have a higher risk of developing spinal stenosis. Trauma to the spine triggers the body’s natural repair process, which involves inflammation. If the spinal injury isn’t properly treated, the swelling can become chronic and may compromise the space in the spinal canal, leading to stenosis.
Will I Have Spinal Stenosis If My Parents Have It?
You won’t necessarily have spinal stenosis if your parents have it. The condition isn’t thought to be inheritable, though genetic factors can influence your risk of developing spinal stenosis.
A 2015 study evaluated the influence of genetic factors compared to environmental factors for lumbar spinal stenosis. It concluded that lumbar spinal stenosis is highly genetic and disc degeneration is one way in which genetics can affect spinal stenosis.
How Long Can I Live With Spinal Stenosis?
You can live with spinal stenosis for the rest of your life. This spinal condition isn’t life-threatening, although it may be disabling in its severe forms.
With this in mind, if spinal stenosis is left untreated, it can lead to serious, potentially-permanent nerve injury. One form of nerve injury that may result from lumbar spinal stenosis is cauda equina syndrome, which occurs when all of the nerves in the lower spine become compressed. If cauda equina syndrome isn’t properly treated, it can lead to permanent paralysis in one or both legs and permanent loss of bowel or bladder control.
Seek out immediate medical attention if you’ve been diagnosed with spinal stenosis and experience any of the following signs of cauda equina syndrome:
- Severe lower back pain
- Saddle anesthesia, which is loss of sensation in the buttocks, perineum, and inner thighs
- Loss of bladder or bowel control
- Loss of sensation in both legs
- Loss of motor function in both legs
- Lost or reduced reflexes
What is The Final Outcome of Spinal Stenosis?
The final outcome of spinal stenosis depends on the severity of the condition, the treatment plan, and how soon the patient sought out treatment.
The Outcome of Spinal Stenosis With Non-Surgical Treatment
For some patients, non-surgical therapies fully resolve spinal stenosis. This is often the case when spinal stenosis is addressed in its early stages. Treatments that may help patients recover from spinal stenosis without surgery include:
- Physical therapy
- Rest and lifestyle modifications
- Anti-inflammatory medication
- Chiropractic care
- Acupuncture
- Massage therapy
- Epidural steroid injections
For patients who improve with non-invasive treatments, it’s crucial to keep up with spinal care recommendations, such as maintaining proper posture, investing in a supportive desk chair, staying active, and avoiding activities that strain the spine.
The Outcome of Spinal Stenosis With Surgical Treatment
Patients who don’t recover after six to 12 months of non-surgical spinal stenosis treatment may need surgery for symptom relief. Thankfully, decompression surgery generally provides good outcomes for spinal stenosis patients, offering long-term relief from back pain and neurological symptoms.
Decompression surgery for spinal stenosis involves alleviating nerve compression by creating more space in the spinal canal. This is most commonly achieved with a laminectomy. This form of decompression surgery involves removing a small portion of the lamina (the roof of the spinal canal) to open up the spinal canal.
Oftentimes, surgeons perform spinal fusion with decompression surgery to avoid spinal instability. Fusion involves permanently merging the affected vertebrae with bone graft material. This eradicates all motion at the targeted segment.
Unfortunately, spinal fusion can lead to mobility restrictions in spinal stenosis patients. This, combined with the risk of adjacent segment degeneration, can compromise the outcome of surgical spinal stenosis treatment.
What is The Newest Treatment For Spinal Stenosis?
The newest treatment for spinal stenosis is minimally-invasive spine surgery with the TOPS System. This device has long been used abroad to restore mobility and resolve symptoms in spinal stenosis patients. But, it’s only beginning to gain prominence in the United States as a safe, effective alternative to spinal fusion surgery.
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The TOPS System is a dynamic spinal implant that creates a controlled range of motion in the spine. It’s designed to treat lumbar spinal stenosis and spondylolisthesis. Unlike spinal fusion, the TOPS System allows patients to recover quickly after surgery and regain the ability to move the spine in all directions without the risk of instability.
Contact a specialist in your area to learn more about spinal stenosis and the latest innovations available to treat it.
What is The Best Painkiller For Spinal Stenosis?
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If you’re suffering from spinal stenosis pain, you know that it can disrupt your daily activities. Unfortunately, severe spinal stenosis pain often limits patients’ mobility, making it difficult to perform basic tasks.
Painkillers are commonly included in spinal stenosis treatment plans. In combination with physical therapy, lifestyle modifications, and other therapies, pain medications may help alleviate patients’ symptoms.
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In this article, we’ll discuss the best painkillers for spinal stenosis, as well as other treatment routes to consider.
Why is My Spinal Stenosis So Painful?
Spinal stenosis is painful because as the spinal cord narrows, it puts pressure on the spinal cord and nerve roots. When these nerves become compressed, it causes pain, cramping, weakness, and/or tingling that can radiate from the back to the buttocks and down the legs.
Additionally, spinal stenosis can become more painful with certain motions and activities. These includes:
- Long periods of walking
- Jumping
- Excessively bending and/or twisting the spine
- Contact sports, like football, basketball, and hockey
- Lifting with a rounded back
How Do You Prevent Spinal Stenosis From Getting Worse?
To prevent spinal stenosis from getting worse:
- Avoid motions and activities that strain the spine.
- Start a low-impact exercise routine to maintain mobility, flexibility, and muscle strength.
- Work on improving your posture, as proper posture alleviates strain on the spinal tissues and structures.
- Quit smoking and using nicotine products, as nicotine reduces blood flow to your spine.
- Maintain a healthy weight, as extra body weight puts extra stress on the spine.
- Practice gentle stretches to prevent muscle tension, which can worsen spinal stenosis pain.
What Helps Relieve Severe Spinal Stenosis Pain?
Medications, physical therapy, alternative treatment methods, and surgery can help relieve severe spinal stenosis pain.
Physical Therapy
Physical therapy is one of the most effective non-surgical treatment options for spinal stenosis. PT helps alleviate pressure on the spinal nerves by promoting proper spinal alignment through targeted exercises, stretches, and alternative therapies like heat/cold therapy and electrical stimulation.
The benefits of physical therapy for lumbar spinal stenosis include:
- Reduced pain and stiffness
- Relief from nerve compression
- Strengthened abdominal muscles
- Improved lumbar spine alignment
Lower Back Pain Medication
Lower back pain medication for severe spinal stenosis pain may include NSAIDs, antidepressants, anti-seizure medication, or corticosteroid shots. Medication can provide near-immediate relief from severe spinal stenosis pain, but may carry the risk of side effects and complications.
- NSAIDs
NSAIDs, or nonsteroidal anti-inflammatory drugs, are common medications used to treat pain and inflammation. They’re available over the counter in the form of Advil, Aleve, and Motrin, as well as in prescription-strength varieties.
- Antidepressants
Antidepressant medications may help with severe spinal stenosis pain by boosting levels of specific neurotransmitters in the spinal cord. These neurotransmitters lessen pain signals, leading to moderate pain relief. Unfortunately, antidepressants can take several weeks to provide significant relief from spinal stenosis pain.
- Anti-seizure medication
Certain anti-seizure medications, including gabapentin and pregabalin, can help alleviate pain stemming from nerve damage.
- Epidural steroid injections
Epidural steroid injections are commonly used for lower back pain caused by inflammation in the spinal nerves. The corticosteroid in the shot removes the proteins that cause swelling in the spinal nerves, leading to spinal stenosis pain relief.
However, physicians generally only allow patients to receive two to three injections per year. In excess, these injections can cause tissue damage.
- Muscle relaxants
Muscle relaxants can improve muscle spasms, numbness, tingling, and radiating pain caused by spinal stenosis.
What is The Best Muscle Relaxer for Spinal Stenosis?
The best muscle relaxer for spinal stenosis can vary from patient to patient. However, the best options include baclofen, cyclobenzaprine, and methocarbamol.
- Baclofen
Baclofen is an antispastic drug that’s widely used to treat muscle spasms in spinal cord conditions, including lumbar spinal stenosis. It’s FDA-approved to treat symptoms of muscle spasticity caused by spinal conditions. By influencing the spinal nerves, baclofen has been found to alleviate pain, improve muscular motion, and loosen stiff muscles.
The most common side effects of baclofen include drowsiness, weakness, dizziness, difficulty sleeping, nausea, more frequent urination, headaches, and constipation.
- Cyclobenzaprine
Cyclobenzaprine relieves muscle spasms from musculoskeletal conditions by working in the brain to reduce muscle hyperactivity. It may be used in patients with lumbar spinal stenosis to reduce pain and improve function. Unfortunately, cyclobenzaprine stops being effective after two to three weeks of use.
The most common side effects of cyclobenzaprine include clumsiness, unsteadiness, fainting, confusion, dry mouth, constipation, drowsiness, nausea, and heartburn.
- Methocarbamol
Methocarbamol blocks pain signals that enter the brain, providing relief from pain and muscle spasms. It has less of a sedating effect and lower rates of abuse when compared to other muscle relaxers.
The most common side effects of methocarbamol include drowsiness, dizziness, stomach upset, nausea, vomiting, lightheadedness, headaches, and blurred vision.
What is The Best Treatment for Spinal Stenosis at L4 and L5?
The best treatment for spinal stenosis at L4 and L5 that doesn’t improve with non-surgical methods is spinal decompression with the TOPS System.
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Spinal decompression is widely performed for spinal stenosis. It involves alleviating pressure on the spinal nerves by removing structures or tissues. Laminectomy, a common form of spinal decompression for spinal stenosis, involves removing some or all of the lamina, which is the piece of bone that covers the back of the spinal canal.
Spinal fusion has conventionally been performed after spinal decompression surgery to prevent instability. Fusion involves using bone graft material to permanently connect the affected vertebrae. Unfortunately, this process permanently limits patients’ mobility and creates the risk of adjacent segment degeneration.
The TOPS System is an excellent alternative to spinal fusion for severe spinal stenosis at L4 and L5. It’s a mechanical implant device that replaces the tissues removed during the decompression procedure. It also creates a controlled range of motion, allowing patients to bend, flex, and twist without pain after the operation.
If you’re suffering from spinal stenosis symptoms that don’t improve despite conservative therapies, find a specialist in your area to learn more about the latest treatment options.
How Do You Fix Spinal Stenosis Without Surgery?
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Spinal stenosis is a leading cause of chronic back pain among older adults. It typically results from age-related wear and tear on the spine, which causes the spinal canal to narrow. With spinal stenosis, spinal structures often press on nearby nerves, leading to pain, numbness, tingling, and related symptoms.
Patients who have received a spinal stenosis diagnosis may be concerned about requiring surgery to fix their symptoms. While severe forms of this condition generally require surgery, there are various non-surgical methods of treating spinal stenosis in its earlier stages.
This article will discuss the existing methods of treating spinal stenosis without surgery. We’ll also explore current surgical treatment options for severe spinal stenosis.
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Can Spinal Stenosis Get Better Without Surgery?
Most spinal stenosis cases can be successfully treated without surgery. In fact, an estimated 70% of patients with lumbar spinal stenosis can effectively manage their symptoms with non-surgical treatments alone. Only 10% to 15% of lumbar stenosis patients must undergo surgery for their symptoms.
Although spinal stenosis patients often don’t require surgery, prompt treatment is essential to recovering from this condition. Patients generally need a combination of conservative therapies, such as physical therapy, anti-inflammatory medications, lifestyle changes, and steroid shots, to recover.
Can You Reverse Spinal Stenosis Naturally?
Unfortunately, spinal stenosis isn’t “reversible” without surgery. Once the spinal canal has narrowed, surgery is the only way to open it back up. However, it is often possible to experience lasting relief from spinal stenosis symptoms with natural treatments alone.
To treat spinal stenosis naturally, start by scheduling prompt appointments with a spine specialist in your area. You’ll need to be monitored by a skilled medical professional and receive personalized recommendations throughout your recovery process.
With that said, physical therapy and lifestyle adjustments are among the best natural treatments for spinal stenosis.
Physical Therapy For Spinal Stenosis
Physical therapy is widely recommended for spinal stenosis patients. It can benefit patients recovering from spinal stenosis naturally, as well as those recovering from spine surgery.
In physical therapy, patients generally receive a personalized selection of exercises and stretches. These are designed to improve muscular support for the spine while promoting mobility. Additionally, your physical therapist may recommend alternative therapies, such as acupuncture, massage therapy, and electrical stimulation, to naturally encourage healing.
Lifestyle Adjustments For Spinal Stenosis
Adjusting your lifestyle can have a major impact on your spinal stenosis recovery process. Aspects of your lifestyle including your exercise routine, weight, and diet can make the difference in your ability to heal from spinal stenosis.
Your weight affects the amount of strain on your spine when you stand, walk, and exercise. Excess weight can place pressure on the intervertebral discs and spinal nerves, increasing your risk of developing neurological symptoms.
Additionally, your exercise routine can help or hinder your spinal stenosis recovery. Exercising regularly is important for spinal stenosis patients to remain mobile, retain muscle strength, and promote circulation. However, avoid activities that put the spine at risk (such as weightlifting, gymnastics, and contact sports).
What is The Newest Treatment For Spinal Stenosis?
Traditionally, spinal stenosis surgery has involved laminectomy with spinal fusion. Laminectomy alleviates nerve compression by extracting some or all of the lamina. Spinal fusion prevents instability after laminectomy by permanently fusing the affected vertebrae.
Unfortunately, spinal fusion creates the risk of adjacent segment degeneration and diminished mobility. Additionally, the rate of patients who require revision surgery after spinal fusion ranges from 9% to 45%.
With spinal fusion’s significant downsides, patients have long sought out treatment alternatives. Recent medical advancements have facilitated the release of many notable new spinal stenosis treatment options, including regenerative therapies, IDET, and non-fusion implants.
- Regenerative therapies
The use of regenerative medicine to treat pain caused by degeneration, disease, or trauma is expanding in the United States. Stem cell therapy, for example, can be used to help regenerate damaged spinal tissue in spinal stenosis patients.
Stem cells can regenerate into any cell type. By injecting stem cells (harvested from the patient or a donor) into the area affected by spinal stenosis pain, it’s possible to promote healing without surgery.
- IDET
IDET stands for intradiscal electrothermal coagulation. It can be used to treat disc degeneration in the lumbar spine without surgery.
IDET involves inserting a needle into the lumbar disc region. A catheter is moved through the needle to gently heat the tough disc exterior. This process can reinforce collagen fibers in the disc exterior, potentially offering pain relief for patients suffering from spinal stenosis caused by intervertebral disc damage.
- Non-fusion implants
Non-fusion spine implants are specialized surgical devices that can be used instead of spinal fusion for spinal stenosis. While these devices come in many forms, they generally serve the purpose of stabilizing the spine without permanently joining the affected vertebrae.
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In cases of severe spinal stenosis, non-fusion implants may be used in conjunction with spinal decompression surgery. The implant can replace the tissues removed during the decompression procedure (typically laminectomy) to prevent stability and preserve motion.
Lumbar Spinal Stenosis Surgery Without Fusion
The TOPS System is a non-fusion spinal implant that facilitates lumbar spinal stenosis surgery without fusion. It’s unique in that it restores spinal motion in all directions, including flexion, extension, axial rotation, and lateral bending. TOPS is designed specifically for patients with spinal stenosis of the lumbar region.
TOPS features internal metal stoppers that replace the natural bony elements that support the spine during axial rotation. It’s also anchored to the spine with four polyaxial pedicle screws for support. But, with a patented crossbar configuration, TOPS applies less force on the screws than fusion implants, allowing for greater longevity.
Rest assured, most spinal stenosis patients recover without the need for surgery. But, if you’re suffering from a severe form of this spinal condition, know that there are many innovative treatment options at your fingertips.
What Causes a Spinal Stenosis Flare-Up?
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Spinal stenosis causes flare-ups from a narrowed spinal canal. With this condition, the spinal cord may press on spinal nerves and/or the spinal cord, causing pain and neurological symptoms.
Flare-ups from spinal stenosis can interrupt your day-to-day life, holding you back from the activities you love the most. But, understanding these flare-ups, their causes, and how to treat them may help you better manage spinal stenosis.
This article will explore spinal stenosis flare-ups, including at-home remedies and surgical solutions that can alleviate them.
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Why Does Spinal Stenosis Come and Go?
Lumbar spinal stenosis tends to have symptoms that come and go. This is especially true when the condition is in its early stages. When spinal stenosis patients suddenly experience symptoms (or worsened symptoms), it’s known as a flare-up.
Spinal stenosis likely comes and goes due to nerve compression. Although the spinal canal is narrowed with this condition, the spinal structures may not press on spinal nerves. However, if various movements or lifestyle factors lead to nerve compression, the patient will likely experience a flare-up.
If spinal stenosis worsens, the patient is likely to experience lasting symptoms, rather than periodic flare-ups.
What Causes Spinal Stenosis Flare-Ups?
Factors that can trigger a spinal stenosis flare-up include:
- Prolonged periods of walking or standing
- Poor posture
- Excessively bending, twisting, or otherwise straining the spine
- Being inactive for prolonged periods
- Muscle spasms
Other factors, including smoking and carrying excess weight, can lead to more frequent flare-ups.
How Do You Treat a Spinal Stenosis Flare-Up?
If you’re experiencing a spinal stenosis flare-up, you can likely experience relief with at-home remedies. However, make sure that you’re scheduling regular appointments with a spine specialist, too. If spinal stenosis goes untreated, it can worsen, leading to exacerbated flare-ups.
What Helps Spinal Stenosis Pain at Home?
At-home remedies that can help curb spinal stenosis flare-ups include:
- Over-the-counter medications, such as NSAIDs. These medications offer relief for pain and inflammation, which can help you overcome spinal stenosis flare-ups. But, if over-the-counter options don’t offer adequate relief, you may want to talk to your doctor about prescription spinal stenosis medications.
- Heat and cold therapy. A heating pad can help ease muscle aches and tension, while a cold pack can help ease inflammation and pain.
- Gentle physical activity and stretching. Although it may be counterintuitive, exercise has proven to help alleviate spinal stenosis symptoms. Just make sure that your exercise choices are gentle and low-impact, such as taking short walks or swimming.
- Topical pain relievers, such as Icy Hot or Bengay. These topical medications can help ease spinal stenosis pain when you’re struggling with a flare-up.
In addition to these home remedies, spinal stenosis patients who are suffering from pain flare-ups may benefit from:
- Physical therapy can offer pain relief through muscle strengthening, stretching, and targeted exercises
- Massage therapy, which can alleviate muscle tension and release pressure on the spine
- Acupuncture can provide pain relief and greater mobility by stimulating your body’s healing response
- Chiropractic care, which improves spinal alignment through manual adjustments
What Kind of Trauma Causes Spinal Stenosis?
Spinal stenosis is most often caused by age-related spinal degeneration. Due to accumulated wear and tear over time, many adults experience spinal stenosis in their later years.
However, spinal stenosis can also be caused by sudden trauma to the spine. This may result from an auto accident, sports, or workplace injury.
A vertebral dislocation or fracture can damage the spinal canal. This can lead to displaced bone tissue, which may reduce the open space in the spinal canal. The displaced bone may press on spinal nerves or the spinal cord, leading to spinal stenosis symptoms.
Inflammation after a sudden spinal injury can also contribute to spinal stenosis pain.
What Does a Neurosurgeon Do for Spinal Stenosis?
A neurosurgeon specializes in surgery on the nervous system, namely the spinal cord and brain. Your spinal cord extends from your brain down to your lower back and is responsible for transporting nerve signals throughout your body.
Patients with spinal stenosis may see a neurosurgeon if they’re not responding to non-surgical treatment options after several months or years. A neurosurgeon can advise you on spinal stenosis surgery and whether or not it’s a good fit for you.
You may be a good candidate for spinal stenosis surgery if any of the following are true:
- You’ve tried non-surgical treatments for six to 12 months and haven’t experienced symptom improvement.
- Persistent spinal stenosis symptoms inhibit your day-to-day activities and overall quality of life.
- You’re in severe, chronic pain caused by spinal stenosis.
If you’re a good fit for spinal stenosis surgery, your neurosurgeon can perform a laminectomy with or without spinal fusion. A laminectomy is a form of spinal decompression involving part of the lamina, a bone covering the back of the spinal canal. Removing a section of this bone can relieve nerve compression caused by spinal stenosis.
Spinal fusion has conventionally been performed after spinal decompression. It prevents instability by permanently fusing the affected vertebrae using a bone graft. Unfortunately, this process also limits patients’ mobility and creates the risk of adjacent segment disease, among other complications.
Progressive and Reliable Lumbar Spinal Stenosis Surgery Options
Patients now have spinal fusion alternatives to consider for lumbar spinal stenosis surgery. A non-fusion spinal implant, like the TOPS System, is an innovative solution that stabilizes the spine without compromising the patient’s motion.
The TOPS System is specifically designed for lumbar spinal stenosis and spondylolisthesis. It’s implanted after spinal decompression to establish a controlled range of motion in the lumbar spine. In addition to greater spinal mobility, the TOPS System provides a much shorter recovery period when compared to spinal fusion.
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If you’re suffering from persistent spinal stenosis flare-ups, schedule an appointment with a spine specialist to learn more about the advanced treatment options available today.
What Causes Spinal Stenosis?
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Understanding the potential causes of various medical conditions can help protect your health for years to come. This is certainly true of back pain, which is one of the most prominent medical problems today. It affects an estimated eight out of 10 Americans at some point in life.
Spinal stenosis is a common source of chronic back pain. It develops when the spinal canal narrows, often due to age-related changes in the spine. Working to prevent spinal stenosis can help preserve the condition of your spine so that you can remain mobile in the later stages of life.
In this article, we’ll discuss spinal stenosis and its most common causes.
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What is Spinal Stenosis of The Lumbar Region?
Spinal stenosis is a tightening of the open space in the spinal canal. It’s known as lumbar spinal stenosis when it occurs in the lumbar spine (the lower portion of the spine).
With less open space in the spinal canal, structures may start to compress spinal nerves and the spinal cord. Known as spinal nerve compression or impingement, this effect of spinal stenosis can lead to a range of symptoms, which we’ll discuss below. In mild cases of spinal stenosis that don’t involve nerve compression, patients may not experience any symptoms.
What Are The Symptoms of Spinal Stenosis?
Spinal stenosis can trigger a broad range of symptoms, including:
- Persistent lower back pain
- Neurological symptoms (numbness, weakness, and tingling) stemming from the lower back to the buttocks, thighs, and legs
- Sciatica (burning pain that extends from the lower back to the buttocks and backs of the legs)
- Foot drop (weakness in the foot that causes it to slap on the group while walking)
In cases of severe spinal stenosis, patients may also have trouble with bladder and bowel control. If this occurs, patients should seek out emergency medical care, as it may be an indication of cauda equina syndrome.
What Does Spinal Stenosis Feel Like?
Patients with lumbar spinal stenosis often explain that they experience increasing pressure in the lower back when they stand or walk for extended periods. They may need to lean forward to alleviate this pressure.
Additionally, spinal stenosis patients often experience a general sense of fatigue. This is likely because the body must exert additional energy to deal with the symptoms of spinal stenosis.
How Common is Spinal Stenosis?
Spinal stenosis is a fairly common spinal condition. It’s worth noting that degenerative spinal stenosis is significantly more prevalent than congenital spinal stenosis, which results from genetic factors. Degenerative spinal stenosis simply results from age-related changes to the spine, including thickened spinal ligaments and intervertebral disc degeneration.
In one study, the prevalence of congenital lumbar spinal stenosis among U.S. patients was found to be 4.71% for relative stenosis and 2.62% for absolute stenosis. With relative stenosis, the anteroposterior (AP) dimension of the spinal canal shrinks to 12mm. With absolute stenosis, the AP dimension of the spinal canal shrinks to 10mm or less.
In the same study, the prevalence of relative acquired (degenerative) lumbar spinal stenosis among patients aged 60 to 69 was 47.2%. The prevalence of absolute degenerative lumbar stenosis in this age group was 19.4%.
How to Prevent Spinal Stenosis?
Adults of all ages can implement many different strategies to prevent spinal stenosis, including:
Practicing Good Posture
Practicing good posture helps keep your spine properly aligned throughout the day. But, why exactly is it important to keep your spine aligned?
When the vertebrae of the spine are stacked on top of each other in proper alignment, it limits the impact on the spinal tissues with various motions and activities. When the spine is out of alignment, the intervertebral discs and other structures will bear extra impact when you sit, stand, walk, or partake in other activities.
Over time, poor posture can speed up the natural process of spinal degeneration that occurs with age. So, practicing good posture can help ward off this degenerative process to protect your spine against spinal stenosis and related conditions.
Exercising Regularly.
Staying active is crucial for many different aspects of your health, including weight management, cardiovascular health, and muscle strength. But, did you know that it can also help prevent spinal stenosis?
Low-impact forms of exercise like walking, cycling, and swimming help strengthen the muscles of the back that support the spine. Exercise also promotes flexibility, which can increase and maintain your range of motion to prevent stiffness. Additionally, exercise promotes circulation, helping to ensure that your spine receives the oxygen and nutrients that it needs for optimal health.
Keep in mind that high-impact exercises, like contact sports and running, present the risk of spinal injuries and aren’t advisable for patients with back pain.
Sustaining a Healthy Weight.
Your weight affects the amount of impact that your spine must bear with every step. So, maintaining a healthy weight by eating a balanced diet and exercising regularly can help reduce the strain on your spine. Over time, this will lower your risk of developing spinal conditions like spinal stenosis.
What is The Surgery For Spinal Stenosis?
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Spinal stenosis may require surgery if conservative therapies fail after six to 12 months. Surgery for spinal stenosis typically involves laminectomy and spinal fusion.
A laminectomy is a form of spinal decompression surgery. In this procedure, some or all of the lamina, which comprises the back of the spinal canal, is removed to alleviate nerve compression.
Spinal fusion has conventionally been done after spinal decompression to stabilize the spine. But, given that it limits spinal mobility and doesn’t always alleviate the patient’s back pain, alternative treatment methods have recently been developed.
The TOPS System is one spinal fusion alternative that creates a controlled range of spinal motion after laminectomy. Designed to be used for lumbar spinal stenosis and spondylolisthesis, this non-fusion implant can resolve pain and neurological symptoms without compromising spinal mobility.
If you’re suffering from symptoms of spinal stenosis, contact a spine specialist in your area to learn about your treatment options.
What Is the Latest Treatment for Spinal Stenosis?
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Conventionally, cases of spinal stenosis that can’t be resolved with non-surgical therapies have been treated with laminectomy and spinal fusion. Laminectomy creates more space in the spinal canal, while spinal fusion stabilizes the spine.
Regrettably, spinal fusion is a major surgery that comes with many significant risks and downsides. Along with a sizable percentage of patients who require reoperation, fusion diminishes patients’ spinal flexibility, which can limit their mobility.
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Considering these risks and drawbacks, many medical professionals have been seeking out fusion alternatives that can effectively treat spinal stenosis patients. Now, we have a greater range of treatment options available, the newest of which allows patients to avoid fusion altogether.
Here, we’ll discuss the latest treatment for spinal stenosis and how it may benefit the spinal stenosis recovery process.
Can Spinal Stenosis Get Better Without Surgery?
First off, let’s consider non-surgical treatment options for spinal stenosis. Many patients with mild to moderate cases of spinal stenosis can improve their symptoms without going under the knife. This claim is supported by recent medical research.
A 2022 paper published in the Journal of the American Medical Association evaluated patients with lumbar spinal stenosis and their condition after three years without operative intervention. About one-third of the patients’ conditions improved, about half of patients experienced no change in their symptoms, and 10% to 20% of patients’ symptoms worsened.
With these results in mind, patients with moderate to severe cases of spinal stenosis often require surgery for lasting symptom improvement.
Spinal Stenosis Severity Gradation and Corresponding Treatment Options for Every Grade
Physicians evaluate the severity of spinal stenosis using a grading system. There are three different grading systems that they may choose between the Lee system, the Schizas system, and the Miskin system.
The Lee and Schizas systems are the most popular spinal stenosis grading systems. The Miskin system was more recently developed but has proven to reduce inconsistencies between neuroradiologists and musculoskeletal radiologists.
Patients diagnosed with mild to moderate spinal stenosis based on one of the systems listed below can consider non-surgical treatment options. However, patients with moderate to severe and extreme stenosis will likely need to consider surgery to attain significant relief.
The Lee Grading System
The Lee grading system is based on the amount of separation of the cauda equina using axial T2-weighted images.
- Grade 0 or No Stenosis: No obliteration of the anterior CSF (cerebrospinal fluid) space
- Grade 1 or Mild Stenosis: Mild obliteration of the anterior CSF space, but the cauda equina are distinctly separated
- Grade 2 or Moderate Stenosis: Moderate obliteration of the anterior CSF space, and some cauda equina can’t be visibly separated
- Grade 3 or Severe Stenosis: Severe obliteration of the anterior CSF space, and no cauda equina can be visibly separated
The Schizas Grading System
The Schizas grading system features seven grades based on the shape, size, and structure of the dural sac, as well as the proportion of rootlets to cerebrospinal fluid. Physicians use axial T2-weighted images to determine a grade using the Schizas system.
- Grade A (No Stenosis or Minor Stenosis): Evident CSF in the dural sac, but the CSF distribution is uneven
- Grade A1: The rootlets are positioned dorsally and take up less than half of the dural sac region.
- Grade A2: The rootlets are positioned dorsally in a horseshoe shape and are touching the dura.
- Grade A3: The rootlets are positioned dorsally and take up over half of the dural sac region.
- Grade A4: The rootlets are positioned in the center of the dural sac region and take up over half of this area.
- Grade B (Moderate Stenosis): The rootlets take up the entire dural sac region but can be differentiated. The sac has a gritty appearance with some CSF.
- Grade C (Severe Stenosis): No rootlets can be identified and no CSF is apparent. The sac has an even, gray appearance with posterior epidural fat.
- Grade D (Extreme Stenosis): No rootlets can be identified and the posterior epidural fat has been destroyed.
The Miskin Grading System
The Miskin grading system is an adapted version of the Schizas grading system. It was altered based on information from radiologists and non-radiologist spinal specialists.
- Normal Spine: The nerve roots are openly spread out, not crowded, and the thecal sac’s anterior margin is flat or convex
- Mild Spinal Stenosis: The nerve roots are mildly crowded and the thecal sac’s anterior margin is flat or a little concave. The nerve roots can be differentiated from the CSF.
- Moderate Spinal Stenosis: The nerve roots are crowded, giving the CSF a grainy appearance. The thecal sac’s anterior margin is concave.
- Severe Spinal Stenosis: The nerve roots can’t be differentiated from the CSF. the thecal sac’s anterior margin is concave or indistinguishable.
What Is the Newest Treatment for Severe Lumbar Spinal Stenosis?
The latest lumbar spinal stenosis treatment has been referred to with many different names, including non-fusion implant and dynamic stabilization system, among others. These names all refer to devices that are used in place of spinal fusion to provide stability and symptom relief. Premia Spine TOPS System is the best one.
Non-fusion implants establish a controlled range of motion in the affected vertebrae. They replace the tissue removed during decompression surgery, ensuring that the spine remains stable after the procedure.
In addition to spinal stenosis, many dynamic stabilization systems can effectively treat spondylolisthesis and degenerative disc disease. But, as the latest treatment option for spinal stenosis, dynamic stabilization systems aren’t yet being used throughout the U.S.
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One example, the TOPS System from Premia Spine, has received the breakthrough designation from the FDA, which allowed the start of an IDE investigation in 330 to 476 patients in the U.S. Patients with single-level spinal stenosis and spondylolisthesis may talk to their doctors about enrolling in this trial if they’re a good candidate for the TOPS System.
Why Consider The Latest Spinal Stenosis Treatment?
Patients suffering from spinal stenosis symptoms have many factors to consider when choosing a treatment route. Although spinal fusion has been used since the early 1900s, it presents many notable downsides. Dynamic stabilization systems have a shorter history, but they were developed with the drawbacks of fusion in mind. Therefore, this route of treatment can help you avoid complications including:
- Adjacent segment disease
- Failed bone fusion (pseudoarthrosis)
- Lost spinal mobility
- Back muscle atrophy
Spinal stenosis patients should speak with an experienced spine specialist to find the right treatment option for their needs.
What Are The Symptoms of Severe Spinal Stenosis of The L4-L5 Segment and How to Treat It?
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The spine consists of 33 vertebrae stacked on top of each other. Depending on their location, the vertebrae provide different degrees of load-bearing and flexibility for the spine.
The L4-L5 spinal segment consists of the two lowest vertebrae in the lumbar spine. It provides motion in many directions and supports the upper torso.
L4 and L5 undergo heavy impact with day-to-day motions and are highly flexible. This makes them particularly susceptible to injury and chronic conditions, including spinal stenosis.
In this article, we’ll explore severe spinal stenosis of the L4-L5 spinal segment and the symptoms that most commonly accompany this condition.
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A Brief Overview of Spinal Stenosis
Spinal stenosis affects roughly 250,000 to 500,000 people in the United States, making it one of today’s most prevalent spinal conditions. It occurs when the open spaces in the spinal canal become narrower, potentially leading to spinal nerve impingement. Spinal stenosis may also cause spinal cord compression.
What Are The Most Common Spine Segments That Spinal Stenosis Damages?
Spinal stenosis most commonly occurs in the lumbar spine, followed by the cervical spine. Although the thoracic spine may also be affected by spinal stenosis, it’s far less likely.
The lumbar spine includes the L1, L2, L3, L4, and L5 vertebrae. When spinal stenosis affects this area, it’s known as lumbar spinal stenosis.
Lumbar spinal stenosis is most often caused by age-related spinal degeneration. The natural aging process can cause several changes in the spine that trigger stenosis, including:
- Wear and tear on the facet joints of the spine (osteoarthritis)
- Bone spurs
- Intervertebral disc damage (bulging or herniated discs)
- Thickened spinal ligaments
What Are The Symptoms of L4-L5 Damage?
Some patients experience no symptoms from lumbar spinal stenosis. However, if this condition causes nerve impingement, it can provoke symptoms of sciatica.
Sciatica is a diagnosis used to characterize pain in the sciatic nerve. The sciatic nerve stretches from the lower back to the buttocks and down the back sides of the legs. The main symptoms of sciatica include:
- Sharp pain that begins in the lower back and moves down the leg
- Weakness in the leg with motion
- Numbness in the leg, foot, and/or toes
- Tingling and/or pins-and-needles sensation along the sciatic nerve
Damage in the L4-L5 spinal segment may also lead to cauda equina syndrome, in severe cases.
What is Cauda Equina Syndrome?
The cauda equina is a collection of nerve roots located in the lumbar spine. It includes nerve roots spanning from L2 to Co1 in the coccygeal spine. Cauda equina syndrome develops if multiple nerve roots included in the cauda equina are irritated or damaged.
Warning signs of cauda equina syndrome include:
- Bladder and/or bowel dysfunction
- Saddle anesthesia, which occurs when the patient loses sensation in the buttocks, perineum, and inner thighs
- Weakness or paralysis of a nerve root
- Sciatica
- Sexual dysfunction
Left untreated, cauda equina syndrome can cause permanent nerve damage. So, if you’ve been diagnosed with spinal stenosis and experience the symptoms listed above, seek out emergency medical attention.
What is The Best Treatment for Spinal Stenosis at L4 and L5?
In most cases, physicians first recommend a conventional treatment plan for lumbar spinal stenosis at L4 and L5. With early intervention, many patients can recover from this spinal condition without having to undergo surgery.
The most common conventional treatments for spinal stenosis at L4 and L5 include:
- Physical therapy, which may involve strengthening and flexibility exercises, stabilization, joint mobilization, heat or ice therapy, and massage
- Lifestyle and activity modifications, such as quitting smoking and starting a low-impact exercise routine
- Over-the-counter or prescription medications, such as NSAIDs, analgesics, anti-seizure drugs, and antidepressants
- Chiropractic care, which focuses on improving spinal alignment with manual adjustments
- Acupuncture, which may help stimulate the body’s natural healing process
With that said, conventional treatment options can’t correct the narrowing of the spinal canal. Surgery is required to gain more space in the spinal canal and may be required if:
- Conventional treatment options fail to provide relief after six to 12 months
- The patient is at risk of permanent neurological damage
- The patient’s symptoms are severely disabling
What Does Surgery For L4-L5 Spinal Stenosis Involve?
Surgery for spinal stenosis at the L4-L5 segment most commonly includes laminectomy. This procedure involves removing some or all of the lamina to create more open space in the spinal canal and alleviate nerve compression.
The lamina is a small piece of bone that forms part of the vertebral arch. It covers the back of the spinal canal. By removing some or all of this bony spinal component, your spinal surgery can effectively resolve symptoms of spinal stenosis.
Unfortunately, a laminectomy can pose the risk of spinal instability. To negate this risk, many surgeons have paired the procedure with spinal fusion.
Is An L4-L5 Fusion Major Surgery?
L4-L5 spinal fusion involves positioning bone graft material in between the L4 and L5 vertebrae. This causes the vertebrae to permanently fuse over several months. After this procedure, patients have no motion at the fused segment.
Simply put, yes: L4-L5 fusion is a major surgery that must be performed by a neurosurgeon or an orthopedic surgeon. It’s a complex procedure, during which the patient must be under anesthesia. Additionally, the recovery process for spinal fusion can span a full year.
Modern Alternative to L4-L5 Stenosis Surgery Fusion – Premia Spine TOPS System
Considering the risks and downsides of spinal fusion, many patients with L4-L5 spinal stenosis seek out ways to avoid it. Some patients may successfully achieve this feat by committing to a conventional treatment plan, including all recommended lifestyle adjustments.
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Unfortunately, not all patients will experience relief from conventional treatments, even after several months or even years. In these cases, patients may consider spinal fusion alternatives, specifically including non-fusion implants. Modern medical technology has allowed for advanced implants that stabilize the spine after lumbar decompression without compromising the motion of the spine – Premia Spine TOPS System.
Reach out to a reputable spine specialist in your area to learn more about the latest fusion alternatives for L4-L5 spinal stenosis.
Spinal Stenosis and Walking Problems
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Spinal stenosis is a condition that develops when the spinal canal narrows. It typically develops in older age and may affect your mobility. But, does spinal stenosis affect basic movements, like walking?
In this article, we’ll discuss how lumbar spinal stenosis can influence your ability to walk, as well as treatments that can restore your mobility. Rest assured, spinal stenosis and walking problems from the lumbar spine can be resolved with modern therapies.
Does Spinal Stenosis Get Worse With Walking?
First off, let’s go over how spinal stenosis can affect your legs.
With lumbar spinal stenosis, you may experience the following issues that could influence walking activity: back, hip, and leg pain, numbness, and in more serious cases – severe numbness in your legs, issues with the bladder, and even the inability to stand. The spinal canal in the lower spine becomes narrower, this can lead to compression of the nerves that extend from the lumbar spine through the hips, buttocks, and down the legs.
When the lumbar spinal nerves become compressed, it can lead to neurological symptoms in the legs, including numbness, tingling, weakness, burning, and/or cramping. Essentially, spinal stenosis suffocates the nerves supplying the legs.
These neurological symptoms can make it difficult to move the legs and walk normally. Additionally, these symptoms are likely to worsen the longer you walk.
Along with neurological symptoms, spinal stenosis can cause the following walking issues:
- Persistent back pain while walking
- A sensation of pressure in the lower back while walking
- Difficulty lifting the top portion of the foot (known as drop foot)
Can Spinal Stenosis Stop You From Walking?
Spinal stenosis is unlikely to stop you from walking if you seek out prompt treatment. However, symptoms of this spinal condition worsen with time, particularly if you don’t receive treatments aimed at preventing further degeneration.
If spinal stenosis reaches a severe stage, it may lead to excruciating pain and neurological symptoms while walking or sitting. In these cases of late-stage spinal stenosis, physicians often recommend surgery to restore the patient’s ability to walk and carry out other day-to-day tasks.
Does Walking Ever Help Spinal Stenosis?
Although long periods of walking can be painful for spinal stenosis patients, it may also benefit this condition. Walking is a gentle, low-impact activity that can help you stay active with this condition.
The potential benefits of walking with spinal stenosis include:
- Increasing circulation, which promotes healing and nerve health
- Maintaining strength in the muscles that support the spine and preventing muscle atrophy
- Preventing stiffness and tension in the back
- Promoting mood regulation, which can help you maintain a positive attitude throughout your recovery
Of course, you should follow all of your doctor’s instructions for physical activity with spinal stenosis. If you’re not sure whether or not it’s safe to walk, ask your doctor specifically. Your doctor can likely also advise you on how long to walk in a single outing, ensuring that you don’t walk for too long at once.
Is Climbing Stairs Good For Spinal Stenosis?
Climbing stairs is similar to walking in the realm of physical activity. However, walking on a flat surface and walking at an incline present a few key differences for your spine.
In particular, when people climb upstairs, they tend to lean forward at the waist. This brings the lower back out of its usual alignment and tends to make it bend or flex. This position alters how the spine bears impact with each step.
As a result, climbing stairs reduces the amount of space in the spinal canal. This temporarily exacerbates the effects of spinal stenosis, potentially leading to worsened pain and other symptoms.
If you’ve been diagnosed with spinal stenosis, it’s wise to keep climbing stairs to a minimum.
What is The Best Treatment For Spinal Stenosis?
We’ve established that spinal stenosis may diminish your ability to walk and partake in other physical activities. Thankfully, several treatments have proven to be effective in restoring mobility and alleviating symptoms in spinal stenosis patients.
Trusted treatments for lumbar spinal stenosis include:
- Lifestyle adjustments
Physicians often recommend lifestyle adjustments as an early treatment for spinal stenosis. Losing weight may be suggested for overweight and obese patients, as extra pounds place pressure on the spine with each step. Reaching and maintaining a healthy weight will lighten the load on your spine to encourage healing.
- Physical therapy
Physical therapy is a tried-and-true treatment method for spinal stenosis. It’s used both as a non-surgical treatment approach and to support the recovery process after spinal stenosis surgery.
Your physical therapist may implement both a targeted exercise program and a passive treatment program. Targeted exercises for spinal stenosis typically involve strengthening the core and back muscles, which support the spine. Passive PT treatments may include hot and cold therapy, massage, acupuncture, and electrical stimulation.
- Medications
Physicians often recommend pain relief and anti-inflammatory medications to help patients manage spinal stenosis symptoms. These medications may be available over-the-counter or, for more persistent symptoms, require a prescription.
- Epidural steroid injections
Epidural steroid injections can offer fast relief from pain and inflammation in spinal stenosis patients. These injections are generally only implemented in moderate to severe spinal stenosis cases. Additionally, physicians generally only recommend three to four steroid injections per year, as using this treatment excessively can lead to tissue damage.
- Spinal stenosis surgery
If patients don’t experience any improvement after six to 12 months of non-surgical treatment, surgery may be considered. Spinal stenosis surgery typically involves spinal decompression surgery to create more space in the spinal canal and alleviate nerve compression.
To prevent spinal instability, spine surgeons often perform spinal fusion after decompression surgery. Spinal fusion involves permanently fusing the affected vertebrae with bone graft material. Unfortunately, this process limits all motion in the fused segment.
Non-fusion spinal devices can stabilize the spine after spinal decompression without fusion. Also known as motion preservation surgery, this emerging option for severe spinal stenosis can help patients regain mobility.
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Lumbar spinal stenosis and walking problems are closely linked. However, with an appropriate treatment plan, patients can attain pain relief and return to their normal activities. Contact a spine specialist in your area to learn about available treatment options.