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Lumbar Spinal Stenosis

“A common source of leg pain after age 50 that can be simply treated without surgery”

Lumbar spinal stenosis is a narrowing of the central spinal canal that is a  relatively rare condition. It presents with single or multiple radiculopathies. It can be due to arthritic degenerative changes or due to family history. Its prevalence can increase with age, often presenting after age 50. The natural course of  lumbar stenosis is one of stable symptoms or improvement with no deterioration based a 4 year prospective trial but exacerbations can be very painful.

Why your lumbar spinal stenosis hurts.

The symptoms of lumbar spinal stenosis are thought to be related to mechanical  compression of the neural fibers or reduced blood flow to the nerves.

Symptoms

Symptoms can vary widely and can present with little or no back pain. The most common symptoms are:
• Progressive weakness
• Progressive numbness and tingling
• Pseudoclaudication describes buttock, thigh, and leg pain that is worsened  with walking or standing and improved with sitting
• “Shopping cart” sign describes improvement in symptoms while pushing a  shopping cart in forward flexion.

If you are experiencing pain or weakness in the legs, you could be suffering from lumbar spinal stenosis. Our expert doctors at Spine & Sports Medicine of New York use their expertise in innovative assessments to accurately diagnose the pain associated with lumbar spinal stenosis.

Other diseases that can mimic spinal disease include:

• Calcium pyrophosphate crystal deposition
• Intraspinal tumors
• Lateral recess stenosis
• Osteoporosis with fracture
• Paget’s disease
• Radiculopathy
• Scoliosis
• Traumatic

Our Board-Certified Physicians Can Accurately Diagnose the Source of Your Pain

We conduct a thorough clinical evaluation to determine if the pain is generated from lumbar spinal stenosis as well as other conditions that share similar symptoms. We begin our evaluation of your problem with a complete medical history using detailed information gathering tools followed by a focused physical examination. We then confirm our diagnosis with specialized tests which may include x-ray, CT, electrodiagnostic (EMG) studies, ultrasonography, or MRI.

“No surgery is needed to relieve pain related to your lumbar spinal stenosis”

Treatments

The majority of patients with lumbar spinal stenosis may be treated non-surgically.
Often functional rehabilitation with activity modification, postural training, flexion  exercises, conditioning using a stationary exercise bike and use of aquatic programs can be helpful. Up to three fluoroscopically-guided epidural steroid injections within a 6 month period can be very effective in relieving symptoms.

Here’s what you can expect if one of our pain specialists treats your pain:

• Relief of pain to get you back to living.
• Several treatment options available to target the root of the problem
• May be accompanied by physical therapy to strengthen your core musculature
• Body mechanics awareness to eliminate the source of the pain
• Epidural steroid injections may be helpful
• Many patients gain considerable to complete relief with the first or second procedure
• No general anesthesia, surgery or prolonged recovery periods to slow you down from your busy schedule
• Thousands of patients have been helped by our innovative approach to degenerative disc disease.

References

Panagos A. Rehabilitation Medicine Quick Reference-Spine (ed. Buschbacher R.M.) New York: Demos Publishing; 2010. p. 150-151.
Rittenberg JD, Ross AE. Functional rehabilitation for degenerative lumbar spinal stenosis. Phys Med Rehabil Clin N Am. 2003 Feb;14(1):111-20.

This sagittal lumbar MRI  demonstrates narrowing of the central canal at several levels that is characteristic  of lumbar spinal stenosis.

This sagittal lumbar MRI
demonstrates narrowing of the central canal at several levels that is characteristic
of lumbar spinal stenosis.

This axial lumbar MRI demonstrates  narrowing of the central canal at one level which takes on a characteristic trefoil  shape due to associated hypertrophy of the facet joints and ligamentum flavum.

This axial lumbar MRI demonstrates
narrowing of the central canal at one level which takes on a characteristic trefoil
shape due to associated hypertrophy of the facet joints and ligamentum flavum.

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testimonials

To call Dr. Panagos exceptional seems to be a dramatic understatement. Brilliant, realistic, and possessing a bedside manner that is bar none: Dr. Panagos held my hand through a series of epidurals due to a herniated disk. His skill for pain management was able to buoy me through a difficult international job and upon my return, he talked me through the decision to have surgery. Never was I rushed through any of my numerous appointment, but rather, every question was answered with attention and kindness. I would refer anyone to Dr. Panagos with a vote of confidence and with my warmest regards!

Christina M
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