Closing In On Your Lower Back Pain
The general sentiment is that lower back pain (LBP) is a part of aging. Statistics suggest this is true, as over 600 million people worldwide report having some form of back pain. For many, LBP is a mild, muscular-related incident, while for other individuals, lumbar spinal stenosis (LSS) is the underlying issue. Spinal stenosis is the narrowing of the spinal canal, the space where nerves branch out of the spinal cord. This canal narrowing constricts nerves, leading to nerve pain, numbness, and weakness. While LSS can happen almost anywhere along the spine, most cases are in the lumbar region. People with spinal stenosis can experience pain and numbness in the lower back, buttocks, legs, or feet. Prompt diagnosis and treatment are the keys to living with minimal lower back pain.
Spinal stenosis causes
Lumbar spinal stenosis is a common cause of low back pain. Most cases are age-related. Like bones and joints, the spine is susceptible to wear and tear, known as osteoarthritis (OA), over time. This degeneration can reduce the space needed for nerves in the lower back. Spondylolisthesis, the slipping of 1 vertebra forward on another, can lead to a narrowing of the spinal canal. Herniated and ruptured discs can also lead to spinal stenosis. Other less frequent causes include tumors, bone spurs, and Paget's disease of bone. If left untreated, spinal stenosis can lead to weakness of the extremities, nerve damage, and a reduced quality of life. The goal is to diagnose and treat the condition quickly for the best possible outcome.
What's the solution?
Different treatments are available for spinal stenosis, depending on the severity of the issue. Most cases respond to pain medication and physical therapy (PT) performed over a prolonged period. Rest, exercise, and dietary supplements also play a role in strengthening the lower back. Moderate cases respond well to steroid injections applied to the epidural space. Some doctors may recommend radiofrequency ablation (RFA), a non-surgical procedure that destroys the nerve endings responsible for pain. These options all provide varying degrees of relief without the need for surgery.
How surgery can help
If non-surgical options fail to improve symptoms after several months, surgery is a viable option. There are multiple procedures based on the source of spinal stenosis. Each method has advantages that the presiding surgeon will discuss with the patient. The more common surgeries include laminectomy, laminotomy, discectomy, or foraminotomy. These procedures remove part or all of the lamina, herniated disc, or foramen impacting the nerves in the lower back. Spinal fusion is an advanced strategy where 2 vertebrae are joined to create a new, solid piece. What connects these options is the possibility of using minimally invasive surgery (MIS) instead of traditional open surgery
MIS benefits
Minimally invasive surgery uses several small incisions the size of buttonholes to complete the procedure. The endoscope, a thin tube with a camera and light attachment, is inserted through 1 incision. Once inserted, the endoscope projects an image of the lower back, allowing the surgeon to visualize the affected area. For the patient, MIS means smaller scars, less post-operative pain, and faster recovery. Choosing the right surgery will depend on the patient's health, the severity of spinal stenosis, and a thorough discussion of risks and benefits.
Tackle spinal stenosis the right way
Cases of spinal stenosis and resulting LBP continue to rise. Don’t ignore the signs and symptoms of LSS. See a doctor for an assessment and treatment plan to get the pain under control. If surgery is the best course of action, a minimally invasive approach can provide many benefits with minimal downside. After recovery, the patient should experience significantly less lower back pain.
