Saturday, May 21, 2022

When it’s more than a pain in the back

Have you ever been washing your car or watering your lawn or garden and suddenly the water flow stops to barely a trickle because somewhere along the line you caused a kink in the hose? Frustrating isn’t it? Think of how frustrating it is for people when the kink is in their spine instead of their garden hose, and the “loss of water flow” caused by the kink brings on pain, numbness, and weakness in their legs. This is a simple way to describe what happens with a condition called Lumbar Spinal Stenosis (LSS).

What is LSS?  

This condition is one of the leading causes of disability and loss of independence of those over 65 years of age and is becoming much more prevalent with our aging population.

Most often LSS is brought on by degenerative arthritis of the spine, which causes thickening of the spinal joints (think of a swollen arthritic knuckle), flattening and bulging of the spinal discs, and bone spurring into the spinal canal or nerve openings. These changes pinch and irritate the nerves that supply the lower back, buttocks, and legs, leading to a condition known as Intermittent Neurogenic Claudication.

Symptoms

Symptoms of Neurogenic Claudication consist of some combination of discomfort, burning and aching pain, weakness and numbness of the buttocks, legs, calves, and feet. The upright postures of standing and walking make the size of the spinal canal and nerve openings smaller, causing these symptoms to worsen.

Symptoms can usually be relieved by bending forward (opening the canal and nerve openings) at the waist or sitting and resting. Typically people with LSS can perform activities that involve flexing of the waist such as pushing a shopping cart, climbing stairs, or riding a bike easier than standing or walking.

Prognosis

Lumbar Spinal Stenosis (LSS) is a disorder that gets worse over time as spinal degeneration is generally progressive. People with LSS can usually stand or walk for only short periods at a time and their quality of life is significantly affected. Most are relegated to  a more sedentary lifestyle, which leads to further decline in overall health.

LSS is frustrating for both the people that have it and the practitioners that treat it since most common treatments are not effective. Medications may give temporary relief but truly only mask the symptoms as the condition worsens. Interventions such as Physical Therapy and Chiropractic have been shown to give some benefit but rarely significant, long lasting relief. Recent studies also show that Epidural Steroid Injections rarely give any lasting help.

Surgery is an option for only a limited number of people with LSS because of the potential risks associated with surgery in an older population. Among those who do have successful surgery the benefit usually is short-lived, most often for only a couple of years.

Treatment options

Researchers in the US and Canada have developed a new non-invasive treatment approach with the focus of improving standing and walking ability in patients with LSS. The overall goal of the program is to improve quality of life and maintain independence among the growing number of people who have this condition.

Studies recently published in the Journal of the American Medical Association and the Archives of Physical Medicine and Rehabilitation show this approach effective in over 80% of those tested. Other studies have shown this approach to significantly decrease pain and increase the ability to walk, with the improvements lasting for more than 3.5 years.

A local resource is available

Dr. Robert Pinto of Pinto Chiropractic recently completed training in this program and he and his team of skilled doctors, athletic trainers and therapists are bringing this program to Lumbar Spinal Stenosis sufferers in Williamsburg and neighboring areas. Help is available and now even more accessible. You can learn more about Dr. Pinto’s team, services and appointment availability here.


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