Lumbar Spinal Stenosis Doctors 

What Is Lumbar Spinal Stenosis?

For someone experiencing pain in the lower back, you might think it is a common issue that will eventually go away on its own. Unfortunately, this might not be the case if you live with lumbar spinal stenosis. So, what is spinal stenosis of the lumbar region? 

Understanding and addressing this condition is important as it can significantly impact a person's mobility and overall well-being.

Lumbar spinal stenosis is a medical condition that narrows the spinal canal in your lower back. This narrowing can exert pressure on the nerves traveling through the spine. When nerves are irritated or compressed, it can lead to spinal stenosis and sciatica. These conditions cause pain, tingling, numbness, or weakness in various parts of the body, such as the legs, arms, neck, or lower back.

Some commonly asked questions about lumbar spinal stenosis are:

• Is Spinal Stenosis a Permanent Disability? Spinal stenosis can indeed be considered a permanent disability in some cases. This condition can cause significant pain and limit your ability to perform basic day-to-day functions in severe cases.
• What Doctor Treats Spinal Stenosis? Many people ask, "What doctor do you see for spinal stenosis?" In most cases, you would start with your primary care physician. However, depending on how severe your symptoms are, you may need to see a specialist, such as a neurologist or an orthopedic surgeon.
• Is Spinal Stenosis Reversible? It's important to understand that, unfortunately, spinal stenosis is not reversible. However, while spinal stenosis can't be cured in the traditional sense of the word, there are treatments available that can help manage your symptoms.
• What Are the Final Stages of Spinal Stenosis? In the final stages of spinal stenosis, there is increased pain, weakness, numbness or tingling in extremities, and in some cases, loss of bladder or bowel control
• What Is the Newest Treatment for Spinal Stenosis? There are numerous cutting-edge treatment options for spinal stenosis. Some of the most technically advanced are radiofrequency ablation and the Intracept Procedure.

Lumbar Spinal Stenosis vs. Thoracic Spinal Stenosis

Thoracic spinal stenosis, conversely, is a medical condition that narrows the spinal canal in your upper and middle back. This compression can lead to pain, numbness, weakness in the legs, and balance issues. Understanding this often-overlooked form of spinal stenosis is crucial, as it can significantly impact an individual's quality of life.

For someone who is experiencing pain in the lower back or neck, you might be thinking that it is a common issue and that it will just eventually go away on its own. Unfortunately, this might not be the case if you are living with lumbar spinal stenosis.

While lumbar spinal stenosis takes place in the neck or the lower back, symptoms vary depending on where the compression is taking place. Generally, symptoms might not show up until later on in life as the canal gradually narrows over time. However, there are some cases in which symptoms might show up earlier due to an injury or traumatic event.

Causes of Lumbar Spinal Stenosis

There are a variety of causes of spinal stenosis lumbar region. Age-related changes are the most common cause, but injuries, diseases, and genetic factors can also play a role.

A list of common causes of lumbar spinal stenosis includes:

Risk Factors of Spinal Stenosis

Degenerative changes of the spine are seen in up to 95% of people by the age of 50. With lumbar spinal stenosis, individuals over 50 are at the highest risk. Other risk factors include a history of trauma to the spine, being born with a narrow spinal canal, and conditions like rheumatoid arthritis and osteoarthritis. Understanding these causes and risk factors can help in early detection and treatment of lumbar spinal stenosis.

Things to Avoid with Spinal Stenosis

What should you not do with spinal stenosis is hope that it will go away on its own. The truth is that individuals with lumbar spinal stenosis need to be cautious with certain activities and habits. One of the key things to avoid, especially for those dealing with cervical spinal stenosis, is heavy lifting, as it can strain the back and neck, potentially exacerbating the symptoms of spinal stenosis. It's also advisable to steer clear of prolonged activities that require standing or sitting for extended periods, as these can increase discomfort and pain.

High-impact exercises, such as running or jumping, can intensify pain and should be replaced with low-impact activities like swimming or cycling. This is among the crucial things to avoid with cervical spinal stenosis. Maintaining proper posture is essential as slouching or other forms of poor posture can exert additional pressure on the spine, worsening the symptoms.

Smoking is another risk factor as it can reduce blood flow to the spine and contribute to disc degeneration. Being overweight or obese can put extra stress on the spine, so maintaining a healthy weight can help alleviate symptoms. Lastly, it's essential not to ignore pain. Trying to push through pain can cause further injury. Listening to your body and resting when needed is a vital part of managing this condition.

Signs and Symptoms of Spinal Stenosis

Symptoms of lumbar spinal stenosis largely depend on the severity and the level of spinal stenosis progression.

Symptoms of spinal stenosis lumbar include:

• Lower Back Pain
• Neurological Symptoms Such as Numbness, Weakness, or Tingling in the Legs 
• Sciatica
• Difficulty Walking or Standing for Long Periods
• Loss of Bladder or Bowel Control
• Severe Debilitating Pain 

It's important to note that symptoms can vary greatly from person to person, both in type and severity. Also, some people with lumbar spinal stenosis may have no symptoms at all. If you're experiencing any of these symptoms, seeking medical attention promptly is crucial. Early diagnosis and treatment can help manage symptoms.

How to Diagnose Lumbar Spinal Stenosis

At Pain and Spine Specialists, we follow a comprehensive approach to diagnosing lumbar spinal stenosis. Our process involves several steps to ensure an accurate diagnosis and the most effective treatment plan for your lumbar spinal stenosis symptoms.

Review of Medical History

Our specialists will start with a thorough review of your medical history. This includes a discussion about your symptoms, their duration, and any previous treatments or surgeries. We also consider lifestyle factors such as physical activity and occupation that might contribute to your condition.

Physical Examination

Your healthcare provider will conduct a thorough physical examination. This may include assessing the patient's gait, as difficulty walking or gait changes can indicate lumbar spinal stenosis. The provider may also look for signs of nerve damage by checking reflexes, muscle strength, and sensory perception.

Diagnostic Imaging

We may request advanced imaging to get a clear picture of what's going on inside your spine.

Some of these techniques include:

• X-Rays: X-rays are the most common way to diagnose lumbar spinal stenosis. Our doctor takes X-rays of your back and spine, looking for signs of narrowing or degeneration in the spinal canal. X-rays can show whether there are bone spurs or arthritis in the spine.
• MRI: Another test that can help diagnose lumbar spinal stenosis is a magnetic resonance imaging (MRI) scan. An MRI uses radio waves and magnets to create detailed images of your body's soft tissues, ligaments, tendons, and muscles without using harmful radiation like X-rays. This image can show if there are any bulging discs or herniated discs that may be contributing to compression on nerves, which causes pain down the leg when you walk or stand up from sitting for too long.
• CT Scan: The CT scan, a combination of X-rays and computer technology, can show detailed images of your bones, discs, and other tissues. Our lumbar spinal stenosis doctors in Maryland use CT scans to see if there is any narrowing of the spinal canal or any bone spurs that might be pressing on nerves.

Nerve Tests

In certain cases, we may need to conduct nerve tests, such as electromyography (EMG), to evaluate the electrical activity produced by our nerves and muscles. This can help determine whether you have nerve damage from spinal stenosis.

How to Diagnose Stenosis with Nerve Blocks

Nerve blocks are a valuable tool in diagnosing conditions like degenerative spinal stenosis. They help identify the specific source of pain by temporarily blocking the transmission of pain signals from specific spinal nerves or joints.

This category of injections include:

• Facet Joint Injections: Facet joints are small joints at each spine segment that provide stability and help guide motion. If lumbar spinal stenosis is causing inflammation or arthritis in these joints, it can lead to back pain. By injecting a local anesthetic into the facet joints, we can determine if they are the source of the pain. If the pain subsides after the injection, it confirms that the discomfort originates from the facet joints.
• Epidural Steroid Injections: Epidural steroid injections are used to reduce inflammation around the nerves in the lumbar spine. If the pain significantly reduces or disappears after this injection, it suggests that the pain is likely due to nerve inflammation or compression in the spinal canal, which are common symptoms of lumbar spinal stenosis.
• Sacroiliac (SI) Injections: The sacroiliac joints are located at the bottom of the spine and connect the sacrum to the hip bones. Issues with these joints can mimic the symptoms of lumbar spinal stenosis. An SI injection can help rule out sacroiliac joint dysfunction as the source of pain, thus aiding in diagnosing lumbar spinal stenosis.
• Medial Branch Blocks: Medial branch nerves are small nerves that feed out from the facet joints in the spine and carry pain signals from the facet joints to the brain. Blocking these nerves can help determine if the pain comes from the facet joints or the nerves themselves. If pain relief is achieved, it suggests that the medial branch nerves or the facet joints they supply are the cause of the pain.

Treatment for Lumbar Spinal Stenosis

At Pain and Spine Specialists, we offer a comprehensive range of treatments for lumbar spinal stenosis. Our approach combines cutting-edge technologies with conventional, interventional, and alternative therapies, allowing patients to access effective treatment for spinal stenosis without surgery.

Injection Therapies

Our injection therapies can provide diagnostic information, but they also can provide therapeutic relief.

These injection options include:

• Facet Joint Injections: Facet joint injections can help identify the source of pain and provide relief by reducing inflammation in the facet joints.
• Medial Branch Blocks: By targeting the nerves that supply the facet joints, medial branch blocks can determine if these nerves are causing your pain and provide temporary relief.
• Epidural Steroid Injections: Epidural steroid injections can reduce inflammation and relieve pain in the lumbar spine.
• Sacroiliac Joint Injections: If we suspect your pain is coming from the sacroiliac joints, SI injections can diagnose and treat the pain.
• Lumbar Sympathetic Block: Lumbar sympathetic blocks can relieve lower back pain by blocking the sympathetic nerves.

Advanced Interventional Procedure for Spinal Stenosis

For more severe cases, we offer advanced interventional treatment for stenosis of the spine. These procedures offer patients minimally invasive spinal stenosis treatment without surgery.

• The MILD Procedure for Spinal Stenosis: MILD treatment for spinal stenosis removes parts of the bone or ligaments in your back to relieve pressure on spinal nerves.
• The Intracept Procedure: The Intracept Procedure is a minimally invasive procedure that targets the basivertebral nerve for the relief of chronic low back pain.
• Radiofrequency Ablation: Radiofrequency ablation uses heat produced by radio waves to target specific nerves and temporarily turn off their ability to send pain signals.
• Vertiflex: Vertiflex is a minimally invasive procedure that inserts a small spacer to keep the spinal canal open and relieve pressure on the nerves.

Conventional Treatments

In addition to our state-of-the-art procedures, we also offer non surgical treatment for spinal stenosis like:

• Medication Management Programs: We can recommend a variety of medications to control pain and inflammation, improve sleep, and enhance physical therapy participation.
• Referrals to Physical Therapy - Physical therapy for lumbar spinal stenosis typically involves a combination of exercises to strengthen core muscles, improve flexibility, and correct posture. These exercises are designed to reduce the pressure on your spine, which can help alleviate your symptoms.

Spinal Stenosis Natural Treatment or Alternative Treatment

There are several natural or alternative treatments for spinal stenosis that can be considered as part of a holistic treatment plan. When appropriate, we are able to refer patients to our partners at Shakthi Health and Wellness Center.

A few treatments to consider are:

• Acupuncture: Acupuncture is an ancient Chinese therapy uses thin needles to stimulate specific points on the body, which can help reduce the pain and inflammation associated with lumbar spinal stenosis.
• BioMat Therapy: A BioMat uses a combination of far infrared rays, negative ion effects, and the conductive properties of amethyst channels to deliver soothing, deep-penetrating heat. This can promote healing and reduce discomfort.
• Infrared Sauna: Infrared saunas use light to create heat, helping to relax muscles, increase circulation, and reduce pain. For lumbar spinal stenosis patients, regular sessions can help alleviate symptoms.

Choosing the Correct Treatment

Treatments may vary depending on the severity of the condition. Our back pain specialists may recommend over-the-counter pain medications and physical therapy for mild cases of lumbar spinal stenosis. If any of these conservative treatments do not relieve your symptoms, another popular treatment is steroid injections or spinal fusions to help you relieve the pain and reduce inflammation through a series of injections near the spine.

For moderate to severe cases of lumbar spinal stenosis, our spinal stenosis experts may recommend interventional procedures or spinal stenosis surgery. The most common type of surgery for this condition is a laminectomy, also called decompressive surgery. This procedure involves removing portions of the bone, bony growths on disks that are pressing on nerves, and other tissues that may be crowding the spinal canal to take pressure off the spinal cord and nerves.