As people age, their spines change. Structures such as the vertebrae, ligaments, and spinal joints surrounding the lumbar nerves may enlarge or change shape due to degenerative changes, which can narrow the space through which the lumbar nerves pass. This condition, along with its symptoms, is known as spinal stenosis.
According to neurosurgery experts, while younger patients often experience lower back or leg pain due to herniated discs, spinal stenosis typically becomes more common in individuals in their 40s and 50s and is most frequently observed in those in their 60s and 70s.
The primary symptoms of spinal stenosis often involve discomfort in the buttocks or legs rather than in the lower back. While symptoms may not be present during rest, they can manifest as cramping pain and leg weakness after standing or walking for extended periods. Walking for more than 10 minutes can become challenging.
Lumbar disc herniation can produce similar symptoms but is usually more acute, as the disc tears or bulges and causes sudden pain. In contrast, spinal stenosis develops gradually over months or years, making it difficult to identify the exact onset of pain.
Approximately 65% of patients with spinal stenosis are women, a higher proportion than men. Often referred to colloquially as stooped old lady syndrome, this condition frequently results in pain relief when bending forward and is more common among women. In severe cases, patients may need to rest often after walking just a few steps.
Since symptoms develop gradually, many people mistakenly attribute them to natural aging or assume they will improve on their own. This delay can result in seeking medical attention only after the condition significantly worsens. Untreated spinal stenosis can lead to muscle weakness, decreased leg sensation, difficulty walking, and an increased risk of falls.
Kim Jong Tae from the Department of Neurosurgery at the Catholic University of Incheon St. Mary’s Hospital noted, “Older women with osteoporosis have weakened bones that are more prone to fractures from falls. Limited activity can lead to weight gain and vitamin D deficiency, further weakening the bones and potentially causing complications that can make daily life more challenging.”
To address worsening symptoms, seeking medical attention early and receiving appropriate treatment is crucial. Treatment is typically approached in stages, starting with measures such as posture correction, exercise therapy, medication, physical therapy, and possibly injections like nerve blocks, depending on the patient’s condition.
Kim explained, “By conducting precise diagnostic tests early to determine the location and severity of stenosis and implementing customized non-surgical treatments based on these findings, significant symptom improvement can often be achieved, and progression to more severe stages can be prevented.”
Recent advancements in spinal endoscopic surgery now allow for widening the spinal canal through one or two small incisions. Using openings smaller than 1 cm, this minimally invasive technique minimizes scarring and damage to surrounding tissues, reduces bleeding, and shortens recovery time, allowing for a quicker return to daily activities.
However, if a patient has tumors, inflammatory diseases, or spinal deformities, traditional open surgery may be necessary. It is essential to consult a specialist to determine the most appropriate surgical method based on the patient’s specific symptoms and condition.
Kwon Woo Geun of the Department of Neurosurgery at Korea University Guro Hospital stated, “While it’s not possible to completely revert to the previous state, this condition can be effectively managed through various surgical treatments to the point where it minimally impacts daily life. Therefore, patients should not endure pain unnecessarily but should seek proactive treatment.”
Kwon added, “Spinal stenosis results from aging and the associated degenerative changes, so avoiding habits that strain the spine can help alleviate symptoms and prevent worsening. It is advisable to avoid lifting heavy objects and sitting on the floor.”