How do I manage my lumbar spinal stenosis pain?

Question

Hello doctor,

I have had back pain for the last 12 years. I had an L5 S1 disc herniation and later diagnosed with severe lumbar spinal stenosis at l4 l5 as well. My back pain is more critical than the leg pain. However, I have persistent calf and foot spasms and cramping (especially in bed and at night). I am able to exercise and lift heavy objects, but not able to walk more than a mile at a time.

I believe the stenosis is more of an issue right now than the disc herniation, and my MRI confirms the disc is not as bad as it was years ago. i have done physical therapy, acupuncture, chiropractor, and epidural injections, but, my lower back pain remains an issue (especially when standing and walking for a long time). My doctors recommend a laminectomy, though I am scared that surgery may leave me in worse shape than I currently am.

Can I have some advice?
Should I go through with the laminectomy, or should I deal with the back pain since I have built a high tolerance for pain and can do most (but not all) activities?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

You are quite aware of the condition and have managed to live with the issue, but as you say, you cannot walk not than a mile, but it does not seem to be your main issue. If you required to walk longer, then laminectomy will be the solution, but you need to get relief from back pain.

I will hazard a guess that this is from local instability, faceted, or discal. I will say that because that is usually the reason for back pain in patients with disc issues. Lumbar canal stenosis will not often give rise to back pain. I will recommend that you discuss this with your doctor and perhaps go for laminectomy and pedicle screw stabilization as this will help relieve both issues.

I hope this helps.

Thank you.