Dr Nigel Kellow, Consultant Interventional Spine and Pain Physician describes how pain in the buttocks or legs after walking fairly short distances could be caused by spinal stenosis.A stenosis (or narrowing) of the central spinal canal will create pressure on the nerves and in particular, the sciatic nerve.
The pain caused by central spinal canal stenosis tends to stop within a few minutes on resting. This is called spinal claudication. Some people get symptoms of spinal stenosis simply on standing up from the sitting position. This is due to the central spinal canal being compromised simply by slight change in angle of the vertebrae as a result of standing.
Dr Kellow explains how spinal stenosis and other conditions of the ageing spine can be treated using the following approaches:
1. Physical therapy and exercise
The importance of maintaining strength in the muscles supporting the spine cannot be emphasised enough. Regular exercise that strengthens both the thick muscles either side of the spine as well as the supporting abdominal muscles can dramatically reduce the impact of degenerative changes in the lumbar spine.
2. Analgesics and other medications
Painkillers are often needed in order to try to avoid the development of an abnormal gait and posture that often develop as a consequence of spinal pain and which can lead to worse secondary problems, and to ensure continued mobility.
3. Percutaneous image guided techniques
The image guided percutaneous treatment of spinal problems with small incisions or no incision at all is developing very rapidly, from spinal steroid injections as epidurals or nerve root blocks, through percutaneous discectomy or disc decompression.
4. Surgery
For advanced cases open surgery may still be required.
