Typical symptoms of lumbar spinal stenosis

  Symptoms of lumbar spinal stenosis can persist for years, slowly worsening over time, with a gradual reduction in standing time or walking distance prior to the onset of these symptoms. In severe cases, the patient may be able to stand for less than five minutes or walk for ten or so steps before the symptoms appear and the patient is unable to continue walking.  Patients with lumbar spinal stenosis cannot work on their feet for long periods of time, cannot go to the mall for long periods of time, and cannot take long walks. Although patients with lumbar spinal stenosis cannot stand or walk for long periods of time due to lumbar spinal stenosis, they often do not experience symptoms when bending over. Since cycling is bending, a typical patient cannot stand and walk for a long time, but can ride a bicycle without symptoms, so many middle-aged and elderly patients with lumbar spinal stenosis with mild symptoms ride a bicycle or a small tricycle when they go out, and have no choice but to “walk with a car”; in addition, since going up a hill or going upstairs is bending, and going down a hill or going downstairs is holding the waist, patients with lumbar spinal stenosis Therefore, patients with lumbar spinal stenosis can go up the hill or up the stairs very easily and freely, but it is very difficult to go down the hill or down the stairs; elderly people like children, and when they hold children, they hold their waist, which means that their lumbar vertebrae are in a posterior extension, while when they carry children, their waist is in a forward bending state, therefore, when elderly people with lumbar spinal stenosis hold children, they can induce the above-mentioned symptoms of lower limb radioactive numbness and pain in the lower limbs, so that they cannot hold children, while they can walk with children on their backs. Likewise, middle-aged and elderly people with lumbar spinal stenosis are prone to the above-mentioned symptoms when carrying a large amount of things in their arms while carrying them on their shoulders and backs, and can walk long distances.  Lumbar spinal stenosis in the general sense refers to the narrowing of the lumbar nerve root canal, mostly in the lower lumbar spine, that is, the lumbar 3 to sacral 1 segment. Currently, it is believed that the main cause is caused by degenerative lumbar spine slippage and degenerative lumbar spine instability due to lumbar spine degeneration, mostly seen in middle-aged and elderly people; lumbar spine slippage can also occur in lumbar spine isthmus discontinuity, mostly seen in young and old people, but often also in middle and old age, due to lumbar spine degeneration, only to cause further narrowing of the lumbar nerve root spinal canal, thus causing symptoms of corresponding nerve damage.  After lumbar nerve root spinal stenosis, it can be due to both direct compression of the lumbar nerve root spine; or it can be due to local venous return obstruction after lumbar nerve root spinal stenosis, which causes ischemia of the corresponding lumbar nerve root. The combined effect of these two mechanisms can result in symptoms of corresponding lumbar nerve root dysfunction, which is referred to as lumbar spinal stenosis. Most of the pathogenesis of lumbar spinal stenosis is based on degeneration and aging of the lumbar spine, and is therefore mostly seen in middle-aged and elderly people.  Since the lumbar spine is not easily compressed or ischemic in the upright or posterior extension state, the lumbar nerve roots are easily compressed or ischemic in the flexion state. Therefore, patients with lumbar spinal stenosis are prone to symptoms when they stand or walk for a long time or maintain a posterior extension posture of the lumbar region for a long time; while they are less prone to symptoms when the lumbar region is flexed, or can relieve symptoms when the lumbar region is flexed after symptoms appear. Therefore, the symptoms of lumbar spinal stenosis are characteristic and dramatic. Although the condition is called “lumbar spinal stenosis,” most patients do not have back pain.  Other conditions that can cause “intermittent claudication” include “intermittent claudication of spinal origin” due to spinal cervical spondylosis or thoracic spinal stenosis, and “intermittent claudication of vascular origin” due to thrombotic vasculitis of the lower extremities, the clinical symptoms of which are The clinical symptoms are different from those of “neurogenic intermittent claudication” caused by lumbar spinal stenosis.