Lumbar Stenosis: Causes, Symptoms, and Rehabilitation Tips

Lumbar spinal stenosis, occasional lower back pain?

Hello, Dr.
Wang.
I usually have a habit of exercising, riding a Ubike for 1.5 hours three times a week, and occasionally hiking for 2 hours.
This is moderate exercise (heart rate above 130 bpm).
Once, I carried a load while climbing stairs for about an hour.
I felt fine the first day, but on the second day, I experienced some pain in certain areas.
By the third day, my entire right leg was inflamed, red, swollen, and warm, with significant pain upon touch, even my big toe hurt (I have had gout attacks in the past).
I went to the emergency room at night and received medication, which helped within half an hour.
The emergency doctor suspected I had sciatica and advised me to follow up.
The outpatient doctor also suspected the same and, after an X-ray, found slight narrowing between the L4-L5 vertebrae and the sacrum.
The doctor said it wasn't serious but recommended physical therapy and provided me with some self-exercise educational materials.
Here are my usual symptoms related to my lower back: I sometimes experience discomfort when engaging in specific positions, such as bending over the sink to wash clothes or doing single-leg Romanian deadlifts (RDL), which causes my lower back to feel sore.
However, switching to a squat position with a straight back alleviates the discomfort.
Additionally, if I walk for more than half an hour, I can feel my lower back.
I tend to sit for prolonged periods while working.
I would like to ask the doctor: 1.
I heard that sciatica is just a description of symptoms and has many underlying factors; is that correct? 2.
Do you think the severe inflammation in my right leg is related to the narrowing of my lumbar spine, or is it more likely due to overexertion or other causes? 3.
Do you believe that the soreness in my lower back from specific positions is related to the lumbar narrowing? 4.
If my lower back only feels sore in specific positions without chronic pain or numbness, is it sufficient to do lower back stretches and strengthen my core muscles at home without needing frequent physical therapy? Thank you!

Hsu Shan-bin, 40~49 year old female. Ask Date: 2022/09/15

Dr. Wang Zhaomin reply Rehabilitation

Sciatica refers to pain caused by compression or injury to the sciatic nerve.
Many factors can lead to inflammation in the legs, presenting with noticeable symptoms of redness, swelling, heat, and pain, which are less related to lumbar spine or neurological issues.
Instead, they are more likely associated with sports injuries, gout, trauma, and other factors.
Long-term poor posture may lead to degeneration of the spine or herniated discs, resulting in lumbar spinal stenosis.
Muscle stretching and strength training can help alleviate soreness and prevent its occurrence.
However, if there is any discomfort, it is advisable to seek medical attention for a professional evaluation before choosing an appropriate treatment method.

Reply Date: 2022/09/15

More Info

Hello! Thank you for your detailed description of your situation. It seems you are experiencing a combination of symptoms that may be related to lumbar stenosis, which is a narrowing of the spinal canal that can lead to pressure on the spinal cord and nerves. Let's address your questions one by one.

1. Sciatica as a Symptom: You are correct that sciatica is more of a symptom than a specific diagnosis. It refers to pain that radiates along the path of the sciatic nerve, which runs from your lower back through your hips and buttocks and down each leg. Sciatica can be caused by various conditions, including herniated discs, spinal stenosis, or even muscle spasms. Therefore, it’s essential to identify the underlying cause of your sciatica to determine the appropriate treatment.

2. Right Leg Inflammation and Lumbar Stenosis: The inflammation and pain you experienced in your right leg could indeed be related to the lumbar stenosis. When the spinal canal narrows, it can lead to nerve compression, which may cause pain, numbness, or weakness in the legs. However, your symptoms could also be due to overexertion from your activities, especially if you were carrying a heavy load while climbing stairs. It’s possible that a combination of factors contributed to your symptoms.

3. Specific Postures and Lumbar Stenosis: The fact that certain positions, like bending over at the sink or performing single-leg Romanian deadlifts, exacerbate your back pain suggests that your lumbar spine may be sensitive to specific movements. This sensitivity could be related to the narrowing of the spinal canal, as certain positions may further compress the nerves. However, if you find relief with proper posture, such as maintaining a straight back during squats, it indicates that your body responds well to ergonomic movements.

4. Home Exercises vs. Rehabilitation: If your back pain is primarily triggered by specific positions and you do not experience chronic pain or numbness, it may be sufficient to focus on home exercises that strengthen your core and improve flexibility. Stretching and strengthening exercises can help alleviate discomfort and prevent further issues. However, if your symptoms worsen or if you experience new symptoms, it would be wise to consult with a healthcare professional. Regular rehabilitation sessions can provide personalized guidance and ensure you are performing exercises correctly, which can be beneficial, especially in the early stages of recovery.

Additional Recommendations:
- Exercise Regularly: Continue your moderate exercise routine, as it can help maintain spinal health. Activities like cycling and hiking are excellent for overall fitness and can strengthen the muscles that support your spine.

- Posture Awareness: Be mindful of your posture during daily activities. When bending or lifting, use your legs rather than your back to avoid unnecessary strain.

- Stretching and Strengthening: Incorporate stretching exercises for your lower back and hamstrings, as well as strengthening exercises for your core and back muscles. This can help alleviate pressure on the lumbar spine.

- Heat and Cold Therapy: Applying heat or cold packs to the affected area can help reduce inflammation and relieve pain.

- Consultation: If your symptoms persist or worsen, consider seeking further evaluation from a specialist, such as a physical therapist or orthopedic doctor, who can provide tailored rehabilitation strategies.

In summary, while your symptoms may be linked to lumbar stenosis, they could also be influenced by your activity levels and specific movements. Maintaining a balanced exercise routine, being mindful of your posture, and incorporating appropriate stretches and strengthening exercises can help manage your symptoms effectively. If you have any further questions or concerns, feel free to reach out. Wishing you a speedy recovery!

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