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The symptoms of low back (lumbar) spinal stenosis occur over time. The pain can be sharp or dull, severe or mild, and intermittent or continuous.

This pain is often worse with certain activities, when nerve root compression occurs. A compressed nerve can result in tingling, numbness, and pain that occurs in the buttocks and radiates down the back of the thigh (sciatica). If stenosis occurs in the cervical (neck) area, the patient may have weakness and spasticity in the arms.

According to statistics, lumbar spinal stenosis occurs in around 10% of the population. It most commonly occurs in those over age 50.

Spinal stenosis affects both men and women, and is most common between the ages of 50 and 70 years. In addition, it may occur in younger people who are born with a narrow spinal canal and those who experience spine injury.

If you are experiencing back pain and associated leg symptoms, the doctor will take a detailed medical history and conduct a physical examination. In addition, he/she may order some diagnostic tests to assess your condition. These include:

. Magnetic resonance imaging (MRI) - This noninvasive test uses radiofrequency waves and a magnetic field to allow for a detailed view of the soft tissues of the spine.
. Computed tomography (CT) - This scan uses x-ray beams and a computer to make 2-dimensional images of the spine.
. Myelogram - This is a specialized x-ray that involves the injection of dye into the spinal canal through a spinal tap.
. Doppler ultrasound - This noninvasive test uses sound waves to evaluate blood flow of the peripheral arteries, which supply the legs.

The treatment of spinal stenosis depends on measures to stop the pain and control the symptoms. Options include:

Medications - Commonly prescribed medications include nonsteroidal anti-inflammatory drugs (NSAIDs), which include naproxen and ketoprofen. Analgesics are used for pain, and steroids are used to reduce inflammation of the nerves.

Physical therapy - The goal of therapy is to instruct you on proper lifting, posture, and walking techniques to strengthen the back, stomach, and leg muscles. Pain relief measures include heat, massage, and electrical stimulation.

Facet joint injections (FJIs) - The doctor inserts small needles into the facet joints along the painful vertebral region of the back. Using x-ray guidance for needle placement, the doctor injects a long-acting anesthetic, with or without a corticosteroid, onto the nerves. According to a recent study, FJIs had a 76% success rate, with a 50% reduction in pain that lasted for up to three weeks.

Epidural steroid injection (ESI) - This involves the placement of a small needle into the epidural space using x-ray guidance. A steroidal agent is injected near the spinal cord to reduce nerve irritation. This procedure has an 80-90% efficacy rate, according to clinical studies.

Spinal decompression therapy - Using a special computerized table, the doctor elongates the spine and applies force to relieve pressure on the discs.