Spinal stenosis is generally not progressive. The pain tends to come and go, but it usually does not progress with time. The natural history with spinal stenosis, in the majority of patients, is that of episodic periods of pain and dysfunction.
A tightened space can cause the spinal cord or nerves to become irritated, compressed or pinched, which can lead to back pain and sciatica. Spinal stenosis usually develops slowly over time. It is most commonly caused by osteoarthritis or “wear-and-tear” changes that naturally occur in your spine as you age.
Spinal stenosis symptoms often become worse over time, but this may happen slowly. If the pain does not respond to these treatments, or you lose movement or feeling, you may need surgery. Surgery is done to relieve pressure on the nerves or spinal cord.
How Long Does Lumbar Stenosis Take to Heal? The amount of time needed to fully recover from lumbar stenosis will differ depending on the patient and the treatment plan. However, generally speaking, most patients recover from spinal stenosis within six months to a year of beginning treatment.
Walking, standing, or extending the lumbar area of the spine can cause symptoms to worsen.
Contact your provider if you have symptoms of spinal stenosis. More serious symptoms that need prompt attention include: Difficulty or poor balance when walking. Worsening numbness and weakness of your limb.
"Unfortunately, nothing can stop the progression of spinal stenosis, since it is due to daily wear and tear," said Dr. Hennenhoefer. "The symptoms of spinal stenosis typically respond to conservative treatments, including physical therapy and injections."
Tingling or weakness in a hand, leg, foot or arm. Problems with walking and balance. Neck pain. Problems with the bowel or bladder.
Grade 1: Mild lumbar stenosis with visible separation of the cauda equina. Grade 2: Moderate lumbar stenosis with some aggregation of the cauda equina so that they can't be visibly separated. Grade 3: Severe lumbar stenosis with no separation of the cauda equina.
Usually, our spine specialists consider surgery only if symptoms such as weakness, numbness, or pain in the arms or legs indicate severe or progressive nerve or spinal cord compression.
The latest lumbar spinal stenosis treatment has been referred to with many different names, including non-fusion implant and dynamic stabilization system, among others. These names all refer to devices that are used in place of spinal fusion to provide stability and symptom relief.
With moderate (Grade 2) spinal stenosis, you may start to experience more pain and discomfort. In this stage, the spinal nerves start crowding, which causes symptoms to worsen. As the stenosis progresses and turns severe Grade 3, the nerves clump together, which makes the pain much harder to manage.
While a spinal stenosis diagnosis will stay with you for life, many patients with spinal stenosis live life in the absence of pain or with minimal symptoms, thanks to a variety of treatment options.
Symptoms usually develop over time or may occur as a sudden onset of pain. You may feel a dull ache or sometimes sharp and severe pain in different areas, depending on which part of the spinal canal has narrowed. The pain may come and go or only occur during certain activities, like walking.
In spinal stenosis, people typically experience less pain with leaning forward, and especially with sitting. Studies of the lumbar spine show that leaning forward can increase the space available for the nerves. Pain is usually made worse by standing up straight and walking.
[8] Pain is exacerbated by walking, standing, or upright exercises. Pain relief occurs with sitting or forward flexion at the waist such as involved with squatting, leaning forward, or lying down. Many patients are asymptomatic when inactive.
Spinal Stenosis
With this condition, it may be preferable to sleep on the sides with the knees curled up (in the fetal position). This helps relieve pressure on the nerve root. Sleeping in a reclining chair or an adjustable bed that allows the head and knees to remain elevated can also relieve pressure on the nerve.
Stage 3 – Stabilization
Bone spurs continue to grow and can narrow the spinal canal, which presses onto the spinal cord or nerve roots. This condition, called spinal stenosis, triggers pressure that can cause limb pain, tingling, and numbness. During this stage, patients may find they lose control of the legs.
Disability: In severe cases of spinal stenosis, a patient can end up permanently disabled. This may be through paralysis, or weakness so severe that it is impossible to stand and move as normal. It is not unreasonable to expect severe stenosis to lead to a person being bound to a wheelchair.
Symptomatic patients with lumbar stenosis typically experience pain on standing or walking, and may have trouble walking for any length of time or for long distances. They need to sit down or lean forward (such as when pushing a shopping trolley) to relieve the pain. The pain typically returns when standing upright.
Acetaminophen (eg, Tylenol), aspirin, ibuprofen (eg, Motrin, Advil), and naproxen (eg, Aleve) are examples of OTC analgesics that your doctor may recommend for spinal stenosis.
As a result, climbing stairs reduces the amount of space in the spinal canal. This temporarily exacerbates the effects of spinal stenosis, potentially leading to worsened pain and other symptoms. If you've been diagnosed with spinal stenosis, it's wise to keep climbing stairs to a minimum.
For example, among patients with stenosis alone, mortality rates were 3.7% for nonoperative treatment versus 2.5% for laminectomy, as assessed in matched cohorts. For patients with spondylolisthesis, mortality rates were 2.3% for nonoperative treatment versus 1.3% for laminectomy and fusion.
The L4-5 level is involved most frequently. Spinal stenosis can be categorized as central and lateral forms, according to the anatomical area of the spine affected.