Understanding Lumbar Spinal Stenosis Symptoms and Stenosis Walking Difficulties
Understanding lumbar spinal stenosis symptoms and stenosis walking difficulties is crucial for those who experience pain and discomfort in the lower back and legs. Lumbar stenosis is a condition that can result in walking limitations, changes to diet and sleep habits, and occasional weakness in the legs, causing significant pain and disability for those affected. To effectively manage lumbar spinal stenosis symptoms, it's important to recognize the signs.
Stenosis walking difficulties can be caused by various factors, such as ankylosing spondylitis, genetic predispositions, or symptoms that start in the spine and refer into the legs. These signs may result in foot pain, leg pain, and walking difficulties, which can significantly impact an individual's quality of life. Often, as physical therapists, we hear of people having trouble walking the grocery store and requiring a cart!
Additionally, lumbar spinal stenosis symptoms can be similar to other conditions, making it essential to obtain a correct diagnosis from a medically reviewed healthcare professional. Stenosis is often diagnosed by a physical therapist or physician. In fact, true spinal stenosis is a clinical diagnosis. That is, images, such as an MRI or X-ray, aren’t as helpful as a physical examination.
This process ensures that the right treatment plan is created to manage the symptoms and improve overall well-being.
When experiencing stenosis walking difficulties, it's essential to consult with a healthcare professional to determine the root cause of the issue. Your healthcare provider may recommend lifestyle changes, specific exercises or weight loss, to alleviate the symptoms of lumbar stenosis. In more severe cases, they may suggest medical treatments or surgical interventions to address the underlying cause of symptoms.
By working closely with a healthcare professional, those experiencing lumbar spinal stenosis symptoms can regain their mobility, reduce pain and discomfort, and improve their overall quality of life. And more importantly, safely improve your ability to walk and stand!
Health care professionals such as physical therapists are available to help diagnose and treat lumbar spinal stenosis symptoms and associated walking difficulties. They can improve pain in the short term and in the long term! By seeking the guidance and expertise of a medically reviewed healthcare professional, individuals can effectively manage their condition, improve their mobility, and reclaim their zest for life. Don't suffer in silence - reach out to a healthcare provider today to take the first step on the road to recovery.
What are the signs and symptoms associated with Lumbar Stenosis?
- Pain, especially in the lower back
- Pain is described as aching, cramping, and numbness in the buttock and/or lower extremity that radiates down the leg or legs
- Pain is relieved by bending over or sitting
- Pain is worse with extension postures such as walking or standing
- Pain progresses over time and without specific cause
- Can be one side or both
How Walking Problems and NHS Information can help Diagnose Spinal Stenosis
Understanding lumbar spinal stenosis symptoms and walking difficulties is crucial for those who experience pain and discomfort in the lower back and legs. Lumbar stenosis is a condition that can result in walking limitations, changes to diet and sleep habits, and occasional weakness in the legs, causing significant pain and disability for those affected. To effectively manage lumbar spinal stenosis symptoms, it's important to recognize the signs and seek appropriate treatment from a healthcare professional.
The NHS outlines signs common for those with spinal stenosis. Symptoms like aching, cramping, tingling, heaviness and occasional weakness in the legs are usually brought on by walking or standing. Symptoms can be eased by sitting or leaning forward.
Patients with lumbar stenosis can also have lower back pain.
However, low back pain with no leg symptoms is usually not thought to be caused by stenosis. Lumbar stenosis is a long term condition, and symptoms are often variable from day to day. Many patients have found that managing their symptoms can help improve their quality of life.
Physical therapists will often use a test called the “Two stage treadmill test” to help diagnose lumbar stenosis. The patient will be asked to walk on the treadmill at a comfortable pace with no incline. The patient will assess their pain while walking with no grade. Then the treadmill will be set to an incline, usually about 15 percent, where the patient will assess their pain again. The test is positive if the patient reports relief when walking on the incline compared to no incline.
When there is an incline, the body’s natural tendency is to lean forward, thus relieving pressure on the stenotic spine. Another, less formal test is the “shopping cart” test. This basically uses a walker or shopping cart and has the patient walk around with it and without it. If there is less pain while using the cart or walker, then stenosis may be present. We can learn a lot with these tests on how to manage pain/symptoms associated with lumbar stenosis. I will usually encourage my patients to use a shopping cart, or potentially a rolling walker while walking in the community.
This may seem counter productive to rely on an assistive device, but if it allows people to get out and enjoy life and be more active with less symptoms then it is worth it.
The concepts centered around these tests can help us understand and guide treatments for lumbar stenosis. Takahashi et. al. found that pressure at the area of stenosis was low while lying and sitting and high while standing. The pressure was increased with extension and decreased with flexion. This study showed that pressure in the spine was related to posture. This finding explains the reason why this test can help, and also why there is relief when bending forward.
There are two main types of stenosis that can affect the lumbar spine. Central stenosis is a narrowing of the spinal canal that houses the spinal cord. Foraminal stenosis refers to the hole that the nerve goes through that runs to the lower half of the body. With foraminal stenosis we can see compression on the nerves that run to the legs. This compression can be what causes symptoms that run down to the leg or foot.
Treatments for Lumbar Spinal Stenosis and Walking Issues: A Comprehensive List of Procedures
Living with lumbar spinal stenosis and walking issues can be challenging. Fortunately, there are several treatments available to help alleviate the symptoms. This comprehensive list of procedures includes a combination of non-surgical and surgical options that can provide pain relief and help improve mobility for individuals suffering from spinal stenosis-related walking problems.
Initially, patients should consult with a healthcare professional to assess the severity of the spinal stenosis and determine the appropriate course of treatment. Physical therapy is often recommended as a non-surgical approach for managing spinal stenosis-related walking problems. It involves a series of exercises, stretches, and modalities that can help strengthen the muscles surrounding the spine, improve flexibility, and reduce pressure on the nerves. Physical therapy is an expert guided treatment pathway that is safe and effective for treating spinal stenosis. It does take time and effort but it is a great way to improve standing and walking ability without surgery or injections.
Core strengthening is even safe for seniors with stenosis. Ice or heat may be an option as well to help with intermittent discomfort.
Check out this book my wife and I wrote about core strengthening!
Another non-surgical option is the use of medications to control inflammation and alleviate pain. This can include anti-inflammatory drugs, muscle relaxants, or pain relievers In some cases, a healthcare professional may suggest epidural steroid injections, which can provide temporary pain relief by reducing inflammation n around the compressed nerves. It's important to discuss any potential risks and side effects of these medications with your healthcare provider before taking them.
If conservative treatments are not providing adequate relief, surgical intervention may be necessary. Spine surgery for lumbar spinal stenosis may involve a procedure called laminectomy, which removes portions of the vertebrae to create more space for the spinal nerves. Alternatively, a healthcare professional might recommend a spinal fusion surgery, in which two or more vertebrae are fused together to provide stability and reduce pain caused by arthritis or disc issues.
Before consenting to any procedure, patients should ensure they have thoroughly reviewed spinal surgery risks and benefits with their healthcare provider. With the proper treatment plan in place, patients suffering from lumbar spinal stenosis and walking problems can achieve significant pain relief and enjoy a better quality of life.
Addressing Foot Pain and Other Related Problems in Spinal Stenosis Patients
Foot problems can occur as a result of spinal stenosis. This is usually caused by the impact on the nerves that exit the lumbar spine and run down to the feet. Slight tingling and pain in the legs is common with stenosis and can be thoughts of as sciatica.
However, if there is a sudden onset of leg weakness, floppy foot, or difficulty walking, seek immediate medical attention. Other signs that may warrant immediate medical attention would be loss of bowel control or numbness that develops in the sacrum.
Many people who have spinal stenosis will say that they don’t have issues when they are using a shopping cart. The cart allows the spine to flex enough to where it relieves pressure on the low back. If you know that there will be a lot of walking, especially at a large department store, take advantage of having the cart available to reduce symptoms.
Don't worry leaning and even bending over is completely safe for lumbar spinal stenosis.
3 great ways to improve walking problems in those with spinal stenosis
1. Standing L stretch
This stretch works to stretch muscles in the thoracic spine while allowing a bend in the waist. Try to find something that you can grab onto that is relatively high. Most people will use a counter top. Place both hands on the surface and walk back until the arms are fully extended. From there, start to bend at the waist while keeping the arms locked out on the counter. Your body will start to look like the letter L. Hold this for a while if it feels good or just go back and forth to work on mobility.
2. Forward flexion:
This tends to be an intuitive motion for those with lumbar spinal stenosis. Much like the shopping cart, the pressure on the spine is reduced when you bend over. Taking a moment and bending over several times may reduce the symptoms down the leg and allow you to walk a longer distance. I remember a patient who loved to hike, but his stenosis symptoms that ran down his legs would prevent him from going as far as he would like.
He would stop periodically and bend over and touch his toes several times and would be able to resume walking with less leg pain. This stretch can be done sitting or standing. If standing, keep the feet shoulder width and fold over at the waist, reaching towards your toes. Go down as far as you can comfortably go then return to the starting position. If you are sitting, sit with your feet flat on the ground. Take a wide base and reach down between the legs.
3. Knees to chest:
If you are able to lay on your back this can be a great move to help reduce pain. Laying on your back and bringing the knees to the chest allows the spine to flex in a slightly different way then bending over. Many people will find relief with this position as it allows the spine to be unloaded.
In conclusion:
Lumbar spinal stenosis is a common cause of back pain in adults that can be addressed through physical therapy. Most people find that flexing or bending their spine forward can provide relief, while extending or leaning back can increase back and leg pain. Walking can be difficult as a result of lumbar spinal stenosis, but there are ways to reduce the symptoms.
Just because you have lumbar stenosis doesn’t mean you have to live in pain or have a reduction in your physical abilities. Believe it or not stenosis caused by herniations, age, and even degeneration is very common. There are both surgical and non surgical options to treat lumbar stenosis, most people can get by without needing to get surgery. The stretches outlined in this article can be useful in maximizing your ability to stay active while living with lumbar stenosis. As always, consult a medical professional before beginning any type of physical program.
Revision Health Services offers physical therapy and wellness in Jacksonville, FL, Nocatee, and St. Johns, Florida. To find out if our services could be the best fit for you, reach out and let's chat!
References:
- https://www.tims.nhs.uk/wp-content/uploads/2020/06/1.8-TIMS-Spinal-Stenosis.pdf
- Kwon JW, Moon SH, Park SY, Park SJ, Park SR, Suk KS, Kim HS, Lee BH. Lumbar Spinal Stenosis: Review Update 2022. Asian Spine J. 2022 Oct;16(5):789-798. doi: 10.31616/asj.2022.0366. Epub 2022 Oct 21. PMID: 36266248; PMCID: PMC9633250.
