Why your patients might be struggling to walk

Lumbar Canal Stenosis is a common condition amongst middle-aged people, especially once they get into their mid-fifties and older.

The classic symptoms they will present with is a heaviness, numbness or pain in their buttocks and legs that is triggered by walking and only relieved by sitting down. This is neurogenic claudication.

If walking is limited to 100 metres or less because of leg pain, then it is likely that claudication is taking place and your patient is suffering from Lumbar Canal Stenosis.

It is possible that such ‘difficulties walking’ may be overlooked unless the doctor is fully aware of the condition of lumbar canal stenosis causing neurogenic claudication.

Diagnosing Lumbar Canal Stenosis

At rest there is very little to find as there is no pain or loss of function.

It is also important to eliminate common complaints with mimicking symptoms, in particular Hip arthritis, Diabetes and Peripheral vascular disease.

After eliminating these possibilities, it may be best to send the patient for an MRI and a spinal consultation.

What’s going on

In effect the lumbar spine is degenerating. The spinal canal is becoming more restricted and compressing the nerves. The pain can be very debilitating.

It’s why sitting down and leaning forward can provide temporary relief. It opens space in the spinal canal and relieves the pressure. Temporarily.

Treatment options

My preference is to view all the options facing your patient before considering surgery, including weight loss, lifestyle changes and hydrotherapy.

I am not an advocate of spinal injections for this condition. At best the pain relief is short lived, if at all.

If the pain is persistent or debilitating, then surgery can alleviate nerve compression by removing bone spurs and ligaments causing the condition.

Procedures may vary from simple decompressions to more complex fusions, depending on the underlying condition found on scans.

As always there needs to be a full consultation with your patient and an extensive diagnosis. Only then can I recommend a way forward.

If you have any questions about a particular patient, please feel free to get in touch on 02 9650 4893 and I will call you back to see how we can help. You can also reach me via ralphstanford@powspine.com.au.

Posted 18 June 2019