What are the typical symptoms of spinal stenosis?

The most common symptom is intermittent claudication, which means the patient is unable to walk long distances continuously and has to alternate between walking and resting. Numbness and pain in the thighs and below the knees often occur

Are there any postures that I should avoid if I have spinal stenosis?

A posture that involves arching the back should be avoided as it narrows the spinal canal further and increases pressure on the nerves. Care should be taken when reaching for objects in high places or when standing for long periods of time

Are there any treatments other than surgery?

Conservative treatments include rehabilitation, drug therapy, and nerve block injections. There is also the option of regenerative medicine, which is currently being researched as a treatment for nerve inflammation and damage

Spinal stenosis causes leg numbness... Why does it happen? Home remedies and the latest treatments

"My legs hurt after walking a little, but they go away when I rest." These symptoms may be a sign of spinal stenosis. This condition causes not only lower back pain, but also numbness in the legs and difficulty walking, and if left untreated, it can significantly reduce your quality of life

This article provides a clear explanation of the mechanism behind spinal stenosis, self-care at home to prevent the condition from worsening, and options for resolving your current pain, from standard treatment to the latest regenerative medicine

table of contents

What is spinal stenosis?

Spinal stenosis is a condition in which the nerve passages in the spinal cord narrow, putting pressure on the nerves and causing numbness and pain. A typical symptom is the inability to walk long distances continuously

Mechanism of spinal stenosis

The passageway through which spinal nerves pass, surrounded by the spine, intervertebral discs, joints, ligaments, etc., is called the spinal canal, and spinal stenosis occurs when the spinal canal narrows with age. Spinal stenosis occurs when nerves are compressed and blood flow to the nerves is reduced due to spinal deformation, bulging intervertebral discs, or thickening of ligaments caused by aging. Generally, it is more likely to occur in middle-aged and elderly people than herniated discs

Symptoms of spinal stenosis

A typical symptom is the inability to walk long distances continuously. This is called intermittent claudication, and the most distinctive symptom is the alternating cycle of walking and resting. Numbness and pain appear in the thighs and below the knees, but surprisingly, in many cases the lower back pain itself is not very severe

There are almost no symptoms when you are resting, but the typical pattern is pain and numbness when standing or walking. As the disease progresses, you may experience weakness in the lower limbs, hot flashes around the anus, difficulty urinating, and urinary problems such as urinary leakage, so caution is required

Reference: Japanese Orthopaedic Association | Orthopaedic Series 8 "Lumbar Spinal Stenosis"

Self-care at home to prevent the condition from worsening!

There are self-care measures you can take at home to prevent spinal stenosis from getting worse

Postures that should not be done (arching the waist) and recommended postures (bending forward)

When you have spinal stenosis, there are postures that you should avoid and postures that are recommended

Postures to avoid: Arching your back

If you bend your lower back backward, the inner diameter of the spinal canal will become even narrower, increasing pressure on the nerves and making the symptoms more likely to worsen. In your daily life, you should be careful about the following movements:

Reaching for high places: Hanging out laundry, grabbing luggage from a shelf, etc
Reading or using a smartphone while lying face down
Sleeping on a mattress that is too soft: Your lower back will sink in, causing your lower back to arch
Long periods of standing work: Standing upright for long periods of time can cause your lower back to arch, so you need to find ways to tilt your pelvis, such as by placing one foot on a platform

It's a movement that we tend to do unconsciously, but simply being conscious of avoiding it on a daily basis can reduce strain on the nerves and help prevent pain

Stretching techniques to relieve pain

For spinal stenosis, stretching is effective in widening the spinal canal and eliminating arching of the lower back

Knee hugging exercise (gas release pose): Lie on your back, hug both knees with both hands, and slowly pull them towards your chest
Cat and Cow (hands-on-hand exercise): Get on all fours, exhale, and arch your back, peeking into your belly button
Stretching the iliopsoas muscle (front of the hip joint): If the front of the hip joint is stiff, it is easy to arch your lower back, so step forward with one foot and assume a position similar to stretching your Achilles tendon, stretching the base of your back leg

However, if the pain or numbness becomes severe, do not force it, but stretch slowly within a range that feels comfortable

Points to note in daily life

It is important not to let your body get cold. This is because poor blood flow makes you hypersensitive, which can lead to increased numbness and pain. Also, don't walk until you feel pain. Instead, walk a little and then sit down and take a break (bend forward) frequently, which will help you increase the total distance you travel

Treatment methods and limitations for spinal stenosis

At present, there is no clear answer as to whether conservative treatment is more effective than doing nothing (letting the condition progress naturally). However, it is common to start with treatment that puts less strain on the body

Conservative treatment methods

In addition to rehabilitation and the use of a corset, drug therapy is also implemented. Vasodilators (prostaglandin E1 preparations) are used to improve blood circulation to the nerves of the spinal cord. If the pain is severe, nerve block injections, which temporarily block pain transmission and suppress inflammation, are also an option as a conservative treatment method

Surgery (decompression/fixation)

If walking difficulties progress and interfere with daily life, surgery to relieve the pressure on the nerve may be considered. However, surgery has its limitations. It is important to note that even if the physical pressure is removed through surgery, there are cases where the damage to the nerve itself that has been compressed for a long period of time does not recover, and only numbness remains

Reference: Japanese Orthopaedic Association | Lumbar Spinal Stenosis Treatment Guidelines
Reference: Japanese Orthopaedic Association | Orthopaedic Series 8 "Lumbar Spinal Stenosis"

Regenerative medicine that addresses nerve inflammation and damage

For those who are reluctant to undergo surgery or who have not seen results from conservative treatments, regenerative medicine offers a new option. Regenerative medicine is a treatment that aims to repair damaged nerve tissue using the power of one's own cells. Treatment uses "adipose-derived mesenchymal stem cells" collected and cultured from the patient, as well as "supernatant fluid (cytokines)" extracted from the culture fluid, which contains active ingredients

This medicine mainly improves symptoms through the following actions

Anti-inflammatory effect (pain relief)
Angiogenesis (improvement of numbness)
Neuroprotective and restorative effects (release of neurotrophic factors)

A major advantage compared to surgery is that no hospitalization is required. It may also be used for symptoms that are not suitable for surgery, making it an option for improving quality of life (QOL). Clinical trial research is being conducted at university hospitals, but it is an elective treatment that is not covered by insurance

Reference: Japanese Orthopaedic Association | Lumbar Spinal Stenosis Treatment Guidelines
Reference: Hokkaido University Hospital | Investigator-led clinical trial begins for regenerative medicine using mesenchymal stem cells and biomaterials in patients undergoing surgery for lumbar spinal stenosis

summary

Don't give up and think, "It's just because of age," but taking early action will help protect your walking ability in the future. First, it's important to have the perspective of managing your symptoms well through self-care and conservative treatment. If this doesn't improve your condition, or if you're unsure about surgery, regenerative medicine is a third option. To ensure you can continue walking on your own two feet, consult a specialist