spinal stenosis

[grams6]

what kind of dr. should I go to if I have spinal stenosis and am having a lot of leg pain and weakness.  The pain in my lower legs and feet are keeping me up at night and make it very difficult for walking.  

[Barbara65]

Thank you anyway for the God bless...we all need a few of those every day.  

[jblessed72]

oops that was for gram6  sorry :)

[jblessed72]

spinal stenosis is generaly caused by degenerative discs and is a narrowing of the spinal canal. this sometimes causes spinal compression and symptoms are depending on the area of the stenosis. this has nothing to do with ligaments or facet joints. you need to see a neurosergeon. i had 3 herniated discs in my cervical area and had a laminoplasty at 4levels no fussion to relieve presure of my spinal cord and maintain mobility. Dr. Simran has given accurate advice and i too would advise you to follow up with your neurosurgeon. my prayers are with you

God bless

[Barbara65]

I have been diagnosed for some time with spinal stenosis (lower back) and weakness on my left side has become a real issue for me lately.  I also have been getting facet joint injections for at least 10 years and Botox injections to lessen the muscle spasms around the damaged nerve.  I had a spinal fusion in 1998 and learned the nerve that goes down my left leg was nearly severed prior to the surgery.  Then in 2006 I had a laminectomy for the disc right above the fusion.  After two unrelated surgeries this summer (fell and broke my shoulder, then bad hammertoes fixed) I have experienced much weakness on my left side, along with the pain associated with the neuroopathy.  I want to keep myself in good shape by walking, riding my exercise bike, etc., but this weakness has become a real problem.  Will PT help to restore the strength?  Do I really have to see a neurosurgeon, or just keep up with my pain clinic shots, and add some PT?  I survived stage IIIc cancer last year and want to really live each day more than ever.  Does progressive spinal stenosis eventually lead to a debilitated body?  What else can I do to prevent giving in to this condition?  
PS  I have lost 4 inches in height, mostly between my neck and hips, in 11 years.

[midasrex]

Hi,

I would disagree (politely) with some of the above. Spinal stenosis is a totally mechanical problem. The ligaments, facet joints, discs and so forth are all thickened and there isn't enough space for the nerves. End of story. You can use a walking aid to help stoop and flex your lumbar spine as that often helps the symptoms but physiotherapy and anti-inflammatories are a bit of a waste of time. The bottom line is (assuming your symptoms of leg pain, weakness and presumerably worse symptoms on standing upright are due to lumbar spinal stenosis) that with spinal stenosis you live with it for as long as you can and then you have an operation if you really find you're becoming incapacitated or miserable. What operation you have depends on what surgeon you see, you can see an orthopaedic or a neurosurgeon, I would advise a neurosurgeon but it's fairly marginal. They may offer you something a bit new, typically an interspinous implant to wedge the affected levels open, something like the X-stop or similar product. My own feeling is that these things are effective in a very few people, not nearly as many as the companies that make them would like us all to believe. The more traditional operation is a laminectomy or lumbar decompression, and if it's done well in the right patient it is a great operation. Go and see a neurosurgeon.

[dr_simran]

Hello grams6,

Spinal stenosis refers to narrowing of the spinal canal, nerve root canals, or intervertebral foramina due to spondylosis and degenerative disk disease. This process usually occurs in the cervical and lumbar spine; it seldom occurs in the thoracic. Spinal stenosis is part of the aging process, and it is not possible to predict who will be affected. No clear correlation exists between the symptoms of stenosis and race, occupation, sex, or body type. The degenerative process can be managed, but it cannot be prevented by diet, exercise, or lifestyle. If symptoms are mild, nonsurgical treatment can be effective. Nonsurgical treatments include physical therapy, anti-inflammatory drugs, and epidural steroid injections. These treatments may be used to manage symptoms on a long-term basis for patients who are not surgical candidates. Urgent surgical intervention is indicated for patients who present with signs and symptoms of spinal cord compression.
Refer: http://www.medhelp.org/posts/show/611469

Best