Medical Professionals
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The Aging Spine: A Common Cause Of Back And Leg Pain
M
ost people will experience back pain at some point in their life. As people age, their joints (such as hips and knees) experience wear and tear. The spine also consists of a complex set of joints that can degenerate. When this degeneration leads to a narrowing of the spinal canal in the lower back, it is referred to as lumbar spinal stenosis. Anatomy
It is important to understand some of the basics of the anatomy of the spine to understand lumbar spinal stenosis. The spinal column consists of a series of bones connected to one another by intervening discs, joints and ligaments. The bones are referred to as vertebrae. The vertebrae have a space within them called the spinal canal where the spinal cord and nerve roots travel. Generally in the low back region the spinal cord has ended and there are nerve roots that supply the legs. The sections of the spinal column have different names, where the low back section is referred to as the lumbar spine.
What happens as the spine ages?
With aging, the normal discs and joints that connect the vertebrae degenerate. This leads to narrowing of the discs and arthritic changes of the joints, which can subsequently lead to pain in the low back. In addition, the ligaments overgrow and bone spurs form. All of these factors together cause the spinal canal to get narrower over time. Once the spinal canal narrows to a certain point, the nerves that travel to the legs get pinched causing lumbar spinal stenosis.
What are the symptoms?
The symptoms of lumbar spinal stenosis include back pain, which can vary depending on the severity of the arthritis. There can also be pain in the buttocks that can travel down the back of the legs, oftentimes referred to as “sciatica.” There can also be numbness or tingling in the buttocks or legs. As the pressure on the nerves roots worsens, weakness can occur, especially in the foot. Patients will often times report that the pain is worse by standing up straight and walking, but gets better with sitting and leaning forward. As time progresses, patients will not be able to walk as far they once did without feeling pain in their legs. Some patients, however, note that leaning forward on a shopping cart will allow them to walk farther without pain.
How is it treated?
The treatment begins first with seeing a physician trained in dealing with the spine and obtaining an accurate diagnosis. The diagnosis is made based on the history and physical exam, and also with X-rays and MRI. Generally, treatment is started with non-surgical options. This includes physical therapy, medications, acupuncture and steroid injections. Oftentimes patients will feel good pain relief from these treatments. If a patient has a poor quality of life due to lumbar spinal stenosis, and non-surgical treatments have not worked or only worked temporarily, then surgery is considered. The main stay for treating lumbar spinal stenosis is to remove the ligaments, bone spurs and other compressive factors from placing pressure on the nerve roots. This process is referred to as decompression, or a laminectomy. The surgeon does not remove all of the vertebrae, only the elements in the back that are placing pressure on the roots. Sometimes a spinal fusion is also needed for various reasons. The laminectomy can be done using a traditional incision, a small “mini-open” incision or a minimally invasive approach. The choice of approach will be determined based on the severity of the stenosis, the individual patient and surgeon factors. Most people experience good pain relief in their legs after surgery and are able to resume their normal lifestyle after recovering from surgery. However, improvement in the back is variable.
In Conclusion . . .
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Spinal Su Total Jo STEVEN BERKOWITZ, M.D., P.A. Bone De ROY D. MITTMAN, M.D., P.A. Workers’ C ARTHUR P. VASEN, M.D., PH.D., P.A. Fo ■ OCEAN OFFICE KENNETH Y. CHERN, M.D., P.A.■ BRICK OFFICE 1200 Eagle Avenue 1640 Route 88 West HARALAMBOS DEMETRIADES, M.D., P.A. Ocean, NJ 07712 Brick, NJ 08724 ARTHUR K. MARK, M.D., P.A. Ph: (732) 458-7866 Ph: (732) 660-6200 CHRISTOPHER J. SPAGNUOLA, M.D., P.A. HOAN-VU T. NGUYEN, M.D., P.A. ARON M. GREEN, M.D., P.A. SUNIL R. THACKER, M.D., P.A. KEVIN C. MCDAID, M.D. PAUL T. HAYNES II, M.D. 294 JOEL P. FECHISIN, M.D. ROBERT P. PANNULLO, M.D. ■ MONROE OFFICE ■ FREEHOLD OFFICE 222 Schanck Road D.O. 294 Applegarth Road, Suite C ADAM M. MEYERS, Freehold,W.NJGREAVES, 07728 KEIRON M.D. Monroe Twp., NJ 08831 Ph: (732)GARLA, 462-1700 Ph: (609) 495-1888 SUDHA M.D. Official Team Doctors Of:
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Lumbar spinal stenosis is one cause of back and leg pain that affects people as they age. It is important to see a physician trained in treating this disease to obtain an accurate diagnosis. Once that is achieved, there are multiple treatment options that can help improve a patient’s quality of life.
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Seaview Orthopaedic & Medical Associates has provided the highest quality of care in Monmouth and Ocean Counties for over 30 years.
Praveen Yalamanchili, MD. Dr. Yalamanchili is a fellowship-trained Spine Surgeon, who completed his training at Emory University in Atlanta, Georgia. A native of New Jersey, Dr. Yalamanchili has returned home after completion of his Fellowship training. He attended medical school at UMDNJ – Robert Wood Johnson Medical School and completed his orthopaedic residency at UMDNJ- New Jersey Medical School. He specializes in the treatment of spinal disorders including degenerative, deformity and trauma and has particular interest in cervical (neck) surgery as well as minimally invasive and motion sparing procedures.
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The County Woman Magazine
www.TheCountyWoman.com
November/December 2014