Lumbar spinal stenosis symptoms may or may not commence as the spinal canal narrows in the lower back. When symptoms are present, they may be diverse, with each patient experiencing a unique set of expressions anywhere below the affected levels of the spinal canal. However, many cases of lumbar stenosis do not present any symptoms whatsoever. Lumbar spinal stenosis is the most common variety of central canal narrowing. It is also a completely expected part of getting older for virtually every adult. Most instances of lumbar stenosis will never progress to symptomatic levels. However, when symptoms do occur, they can range from minor to extreme.
This guide examines the types of symptoms that are usually associated with lumbar central canal stenosis. We will also detail how symptoms can progress as the stenosis worsens over time.
Absence of Lumbar Spinal Stenosis Symptoms
As previously mentioned above, stenosis is normal to experience as we get older. Disc desiccation, intervertebral herniation, osteoarthritis and other factors can all narrow the central canal space and all of these contributors are virtually universal in the lower spinal region. Just because the vertebral canal is structurally narrowed does not mean that symptoms will occur. In fact, the canal must be reduced in patency to a large degree in order to affect the cauda equina, which has replaced the spinal cord in the lower lumbar region; the area most often affected by degenerative stenotic changes.
In essence, a marked narrowing of the lumbar canal can be a completely innocent and asymptomatic event. Statistics show that in most instances, lumbar stenosis will not cause pain or any neurological dysfunction. Some cases might progress to symptomatic level later in life, while others might not. This is why it is always a good idea to monitor the degree of any diagnosed stenotic condition yearly with a spinal neurologist.
Preliminary Stenosis Symptoms in the Low Back
If the central canal suffers suffient impingement, the cauda equina can be affected partially or in totality. This means that single or multiple nerve roots can be compressed within the central canal or the entire structure can be compressed en masse. Once these nerve tissues are functionally limited, symptoms are likely to begin.
It must be noted that similar or identical symptoms can occur if these cauda equina nerve roots are compressed within the lateral recess or even within the foraminal spaces. This can make diagnosis of the actual causative process somewhat difficult, especially when central and foraminal stenosis are both present. Of course, this represents a commonly seen scenario, since loss of neuroforaminal patency is also a virtually universal aspect of the aging process, especially in the lower lumbar levels. Preliminary symptoms might include any or all of the following expressions:
Localized pain might exist and is often accompanied by sciatica pain in the buttocks, legs or feet.
Localized numbness is possible to experience as is numbness in the buttocks, legs or feet.
Paresthesia describes a feeling of intermittent tingling in the buttocks, legs or feet.
Advanced Lumbar Spinal Stenosis Symptoms
If the stenotic changes progress, or remain untreated for an extended time, they often worsen. This is not a rule, but does apply in many instances of significant central canal narrowing. The following are all possible symptomatic expressions of severe central stenosis in the lower back:
Symptoms listed above may continue, may worsen or may decrease in severity. Often pain is slowly replaced by ever-more progressive versions of objective numbness locally and in the buttocks, legs and feet.
Patient may feel a “neurological disconnect” with their legs. This might affect balance, coordination or muscular response.
Patient’s legs might become partially paralyzed in the most extreme cases of lumbar stenosis.
Patient may have a progressively more difficult time standing or walking.
Patient may experience bowel or bladder incontinence.
Patient may express sexual dysfunction.
Finding effective treatment for severely symptom-generating versions of lumbar stenosis is crucial, in order to prevent serious and possibly permanent neurological damage from diminishing the quality of life.