Lumbar stenosis is a common condition affecting around 11% of people. It is more common in people over 50. Patients often complain of low back pain as well as leg pain – which may be in one or both legs. There may also be numbness and/or tingling in the legs. Usually, the leg symptoms, including pain, are brought on by walking or standing for longer periods of time. When resting, people with lumbar spinal stenosis can often be comfortable. Unfortunately, the leg pain when walking and standing can significantly affect quality of life and prevent older patients from engaging with important everyday tasks and with the activities they would like to do.
Lumbar stenosis is caused by normal age related changes in the spine. As we age, some joints and ligaments in the spine may well enlarge, discs can bulge as well. This is a normal finding, but in some people it narrows the space for the nerves that pass down the low back and into the legs – causing symptoms like pain, weakness and tingling that we feel in the legs. Unlike sciatica, the leg symptoms are often only present when using the legs, such as walking and standing, and ease quite quickly when you rest.
Imaging, like MRI, is not usually required to diagnose lumbar stenosis. Your GP, physiotherapist or MSK practitioner can usually diagnose the condition after an examination. 30-50% of people with mild to moderate symptoms will improve significantly with physiotherapy and find they can stand and walk for much longer as a result. You may require pain medication, this should be discussed at your GP surgery.
In more severe cases, or when physiotherapy doesn’t help after a number of months, you may be referred to the MSK department for examination, imaging and further treatment options. If you have persistent leg pain that doesn’t settle with rest, you may talk about the use of spinal injections. A relatively small number of people may go on to consult with a surgeon if their symptoms can’t be managed with the usual treatments.