Lumbar Spinal Stenosis (LSS)

Hai. I'm treating a case of Lumbar Spinal Stenosis in my clinic. Apart from my study i gathered few points from different sources and compiled this post. Please go through it once.Hope this information helps you a lot.

Q.What is lumbar spinal stenosis?

A.  A degenerative medical condition in which the spinal canal is narrowed and presses spinal cord at the level of lumbar vertebra.

Q.How it starts?

A. It starts gradually and develops over a long period of time. 

Q.What are the causes?

A.It may be congenital or acquired through trauma or surgery, local infection, spinal disc herniation, tumour, old age are the causes.

Q.What are the symptoms and signs?

A. Low back ache, pain, cramps, weakness, fatigue, discomfort in calves, thighs, buttocks, legs ,feet , sometimes loss of bladder or bowel control, numbness and pain along posterior part of leg. Mostly bilateral may be unilateral also. 

One most important symptoms is "Limping" or "pseudo claudication" where pain felt only while standing or walking certain distance and ceases while resting. Flexion of waist gives pain relief as the spinal canal space increases on flexion of waist.

Q. What is the differential diagnosis in this case?

A.Similar symptoms are seen in Peripheral Artery Disease(PAD), but pain is not relieved by bending forward and bicycle test is done to distinguish this. Pedaling on a stationary bicycle causes pain, but on bending forward if there's no pain felt, then it is LSS. In PAD there is blockage of artery causing similar symptoms distinguished by Bicycle test or Color Doppler Test.

Q.What are the tests that diagnos LSS?

A. X-ray often is not useful in some cases and requires CT or MRI of lumbar spine, Color doppler test usually diagnoses the condition.

Q. What are remedies in Homoeo for lumbar stenosis?

A. Arnica, Gnaphalium, Agaricus, Ruta, Macroinum, Kali iod, Belladonna, Tellurium are few among many remedies which works well.

Q.Is it curable through medicines or surgery is must?

A.Surgery is unavoidable as damage to the spinal nerves causes more other complications. 

Medication , Home Exercises, Physiotherapy, Spinal injections are useful.