CLAUDICATION / NUMBNESS OF BOTH LEGS (Lumbar Canal Stenosis)
Wear and tear with age can give rise to degenerative disc disease, a condition where there is progressive deterioration of spinal discs and arthritic changes in facet joints. It can also result in the narrowing of the spinal canal due to overgrowth of bone spurs, leading to spinal stenosis, which can cause pain, numbness and weakness in the legs due to compression of the neural elements.
Most of the cases can be asymptomatic.
When symptomatic, one may develop numbness / pain in both legs after walking for a while, which is relieved after sitting or lying down for some time. This is termed as neurological claudication. The time and distance after which this condition develops may vary from person to person, depending on the amount of compression over the nerve.
A few patients have also complained of back pain, along with bladder & bowel symptoms and weakness in the legs.
The evaluation for this condition will usually involve a review of the patient’s medical history and a physical examination, followed by X-rays. Your doctor may advise dynamic radiographs to evaluate if there is any instability.
MRI is usually done to know the level and severity of compression on the nerve and also to assess the surrounding tissue (facets hypertrophy, ligamentum flavum hypertrophy), and condition of the disc.
Prognosis: Most of the patients will get relief from the symptoms by conservative management. Only a few may require surgical management.
It is non-operative management through use of medications, physical therapy, lifestyle modification, posture care and occupational therapy.
Patients with failed conservative management or with severe neurological compromise (progressive weakness of legs / bladder and bowel symptoms), may be treated surgically.