Definition and Symptoms of Lumbar Spinal Stenosis

Lumbar spinal stenosis is a narrowing of the spinal canal that can result in painful symptoms.

 

There are two types of lumbar spinal stenosis:

• Congenital—present at birth. 
• Degenerative—age-related and much more common.

In a healthy spine, there is enough space for nerves to function properly.  When the space in the spinal canal is reduced, pressure is put on nerves, causing pain that radiates from the lower back into the buttocks and down the leg(s).

Symptoms of Lumbar Spinal Stenosis

People with lumbar spinal stenosis typically feel one or more of the following sensations that radiate from the lower back into the legs:  

• Pain
• Numbness
• Weakness
• Stiffness
• Dull cramping
• Uncomfortable tingling or pins-and-needles sensation
• Difficulty with balance

The symptoms of lumbar spinal stenosis usually occur when you stand up straight or walk—when your back is in extension. You may feel relief by sitting or leaning forward—when your back is in a flexion position—because this can relieve compression of the nerves.

Progressive Nature of Symptoms

When lumbar spinal stenosis is degenerative, or age-related, symptoms may worsen over time. This is because the underlying causes of lumbar spinal stenosis—for example, changes in the vertebrae due to arthritis—often continue to progress.

 

It's very common for the symptoms of lumbar spinal stenosis to develop gradually, over several years. In time you may notice that the longer you walk, the more painful the symptoms become.

 

Some people don't pursue treatment right away, thinking the symptoms will improve. As with most progressive conditions, this is often not the case.

 

One clinical study¹ examined patients suffering from symptoms of lumbar spinal stenosis over the course of 4 years found the following:

• 15% showed improvement
• 70% of the cases were unchanged
• 15% worsened
• 38% percent of the patients had progression of disease

This paper suggests that slow progression of spinal stenosis is common, which is to be expected for a degenerative disease process.

Clinical Names for Symptoms of Lumbar Spinal Stenosis

• Neurogenic Intermittent Claudication—Refers specifically to the symptoms of lumbar spinal stenosis.
• Sciatica—A set of symptoms that are sometimes related to lumbar spinal stenosis.
• Radiculopathy—The clinical name for symptoms that originate from the nerves being affected.

Learn more:

• Treatment Options for Lumbar Spinal Stenosis
• How Lumbar Spinal Stenosis Affects Your Anatomy

References:

1. Zucherman JF, Hsu KY, Hartjen CA, et al. A multicenter, prospective, randomized trial evaluating the X STOP interspinous process decompression system for the treatment of neurogenic intermittent claudication: two-year follow-up results. Spine. 2005;30:1351-1358.
2. Fanuele JC, Birkmeyer NJ, Abdu WA, et al. The impact of spinal problems on the health status of patients: have we underestimated the effect? Spine 2000;25:1509–14.
3. Long DM, BenDebba M, Torgerson WS, et al. Persistent back pain and sciatica in the United States: patient characteristics. J Spinal Disord 1996;9:40–58.
4. Boden SD, Davis DO, Dina TS, et al. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 1990;72:403–8.
5. Hart LG, Deyo RA, Cherkin DC. Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey. Spine 1995;20:11–9.
6. Ciol MA, Deyo RA, Howell E, Kreif S. An assessment of surgery for spinal stenosis: time trends, geographic variations, complications, and reoperations. J Am Geriatr Soc 1996;44:285-90.
7. Johnsson K-E, Rosén I, Udén A. The natural course of lumbar spinal stenosis. Clin Orthop Relat Res. 1992;279:82-86.
8. Prevalence of Symptoms of Cervical and Lumbar Stenosis Among Participants in the Osteoporotic Fractures in Men Study (Vogt, et al.) Spine. 2006;31(13):1445-1451.