Lumbar Spinal Stenosis – Chiropractors in Southampton Explain What It Is

LUMBAR SPINAL STENOSIS

What is it?

It is a narrowing of the openings in the spine for the spinal nerves to exit, usually caused as we age and degeneration occurs.

In the lumbar spine these nerves go into the legs to supply the muscles with nerve impulses so they can contract and function.

stenosis PIC

 How do you know you have it?

In the past it was always thought that it was easy to diagnose – if patients presented with low back pain usually accompanied by the complaint that they have begun to experience leg pain on walking which makes them have to stop and stand still for a while before they can continue (usually if the blood supply to the muscles is compromised – also called vascular claudication) or they will need to stop and bend over or sit down so that the spine flexes before they can start to walk again without pain (usually found if the nerve supply to the muscles is compromised, which is called neurogenic claudication) then Lumbar Spinal Stenosis was usually diagnosed.

However, recent research from the USA throws into doubt the accuracy of diagnosis because:

1)      A lot of people have stenosis that can be seen on scans but have none of the above symptoms.

2)      There is no definitive diagnosic test or set of tests to prove that you have spinal stenosis.

3)      The signs and symptoms are very variable.

4)      The indications for surgery are very vague.

5)      Often surgery that increased the space for the spinal nerves to move in made no difference to the patient’s symptoms.

 What is the best treatment for it?

This where the problem lies. If diagnosis is difficult then to undergo a back operation without good outcomes being likely is never a good idea. However, you don’t want to pay for too many conservative treatments that are not going to help either. But you can’t walk far due to leg pain; you have back pain and you want to try to do something to improve your life – what IS best?

Try a short course of Manipulation/Mobilisation/Exercises

At The Avenue Clinic, we will never lose sight of the fact that you might have Lumbar Spine Stenosis if you have the symptoms described above, but we will also not tell you that you definitively have it when evidence suggests that attempts to diagnose are often flawed. Therefore in our opinion, the best advice would be to treat you 4 – 6 times and then review your progress. If you do show improvement in the distance you can walk without having to stop and your back pain reduces then it probably wasn’t stenosis after all, but low back pain with nerve root irritation.

If, however, your problem gets worse or does not improve significantly then we would refer you for further tests and stop treatment. Trying a short, inexpensive course of conservative treatment must make more sense than rushing to undergo an operation that offers no guarantees.

 

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