Lumbar spinal stenosis (LSS) is a narrowing of the spinal canal that occurs in
the lower part of the spine (lumbar region).
The problem with a narrowed spinal canal
is that it reduces the space allowed for nerves to branch out from the
spinal cord. When a nerve in your lower
back becomes pinched, you may feel various symptoms, including:
Pain in your lower back or legs—especially when you stand or walk
Pain relief when you sit, lean forward, or use a cane, walker, or shopping
cart for support when you walk
Numbness, weakness, stiffness, or dull cramping pain in the lower back and
Painful tingling or a pins-and-needles sensation that shoots down the back of
Weakness or fatigue that comes on quickly during activity or exercise
Difficulty maintaining balance
Learn more about how an LSS diagnosis is made.
In many people, LSS symptoms can limit the amount of time you can comfortably
stand and can shorten the distance you can walk comfortably. Restrictions on
mobility can make it difficult—or impossible—to carry out simple
activities necessary for self support, such as shopping or other errands, as
well as work, social, and recreational activities.
This lack of activity can lead to obesity and general physical deterioration,
which may eventually result in heart disease, diabetes, and other serious health
problems. Restrictions on mobility and activity may also lead to depression and
other psychological problems.13
Symptoms of LSS may be categorized as mild, moderate, or severe, based on the
extent of leg pain and pain-related disability.1 Your doctor will assess your symptoms in order
to choose the best possible treatment.
While imaging aids, such as an X-ray or
CT scan, help show your doctor the physical
degree of spinal stenosis, they cannot show the degree of pain or discomfort you
are experiencing. In some cases, the degree of pain or other symptoms may not
relate to what the imaging aids show. You may have very severe symptoms, even
though the X-ray shows relatively little narrowing of the spinal canal.
Just remember, your doctor relies on you to report information about the
severity of your symptoms and how they impact your normal daily activities and
quality of life in order to choose the best treatment for you.
Only a doctor or spine specialist is qualified to make an accurate LSS
diagnosis. Need to find a spine specialist close to
Clinical terms and definitions for LSS symptoms
Generally speaking, the symptoms of LSS are known by your doctor as neurogenic
intermittent claudication and sciatica. Your doctor may also refer to the
standing and walking positions of the spine as extension, and sitting or bending
positions as flexion.
A doctor explains why standing causes pain.
Neurogenic intermittent claudication (NIC)
NIC refers to pain and discomfort in the low back, buttocks, and legs. Symptoms
of NIC are worse while standing and walking (extension), and relieved while
sitting or bending forward (flexion).
This explains why it is often easier to walk up a ramp (because your spine
naturally bends forward) than it is to walk on a level surface. In fact, people
with LSS often lean forward on a grocery cart while shopping to reduce their
Sciatica is often misused as a catch-all name for leg pain. In medical terms,
sciatica (or radiculopathy) means a spinal disc protrudes beyond its normal
position and irritates the radicular nerve, which connects with the sciatic
nerve. The sciatic nerve is the longest nerve in your body. It runs from each
side of the lower spine through the buttocks and hip area, down the back of each
leg all the way to your feet.
Sciatica is only found in a small percentage of LSS patients.
Talk to your doctor about what causes and relieves your symptoms. Your doctor
may recommend tests like the “straight-leg-raise test” to determine
what is causing your symptoms.
Compared to NIC
Sitting may increase symptoms of sciatica, whereas symptoms of NIC can be
relieved by sitting or leaning forward.
A condition related to LSS—cauda equina syndrome
Cauda equina syndrome is caused by pressure on nerves that branch out from the
bottom of the spinal column. While it causes symptoms similar to LSS, cauda
equina syndrome is a more serious condition that can also result in bladder and
bowel problems. If you suspect that you may have cauda equina syndrome, you
should seek help immediately.
This website features a list of surgeons trained to implant the X-STOP Spacer
for treatment of symptoms of LSS. Please note: the X-STOP Spacer is not
indicated for the treatment of cauda equina syndrome. However, the surgeons
listed on this site are experienced at treating patients with LSS.
Find a spine specialist.