When some patients with back and leg pain go to the hospital and are diagnosed with lumbar spinal stenosis after a series of tests, and the doctor recommends surgery, the patient has a complex mindset and a series of questions in his mind: Is lumbar spinal stenosis very serious? Is the physician’s diagnosis correct? Does surgery have to be done? Is there a better treatment option? Usually, most busy outpatient physicians do not have the time to answer these questions in detail, and many patients have to go to several large hospitals to seek confirmation, and finally, they can hardly make up their mind and agree to surgery, at which time there are often well-meaning friends and colleagues who come forward with suggestions, some good and some bad, and the worst suggestion is: “I know so-and-so who is suffering from lumbar spinal stenosis. The worst advice is: “I know so-and-so who has lumbar spinal stenosis and is paralyzed after surgery.” At this point, the patient’s psychological burden is even heavier, and being admitted to the hospital for treatment is like going to a “torture chamber. How can patients treat lumbar spinal stenosis correctly in the process of seeking medical treatment? Here I will give you some common sense, the patient’s heart has a bottom to lumbar stenosis, will treat the disease correctly, and actively cooperate with the doctor’s treatment. What is lumbar spinal stenosis The human spine is composed of more than 30 vertebrae, the front part of each vertebra is cylindrical in shape, called the vertebral body part, and the rear part is surrounded by bone into a ring, called the spinal canal. The anterior part of the spine is weight-bearing, and the posterior part of the spinal canal accommodates the spinal cord and nerves. When the bone tissue and ligamentous tissue structure around the spinal cord grows, the diameter of the spinal canal becomes smaller, resulting in compression of the spinal cord and nerves, and symptoms such as back and leg pain and difficulty walking occur, which is medically known as spinal stenosis. There are many causes of lumbar spinal stenosis, medically divided into two categories: congenital and secondary, with secondary being the most common, in which degenerative changes in the lumbar spine are the most important cause of secondary lumbar spinal stenosis. Similar to the reasoning that machines wear out over time, the human lumbar spine is slightly different in that it repairs itself when it wears out. Some of these repairs are beneficial and some are harmful. The harmful repairs caused by lumbar spine degeneration include bone spur growth and ligamentous hypertrophy, which can cause lumbar spinal stenosis and compression of the spinal cord and nerves. The clinical symptoms of lumbar spinal stenosis are mainly low back and leg pain, but they are different from the low back and leg pain caused by lumbar disc herniation. The pain caused by lumbar spinal stenosis is relatively mild, with slow onset and gradual aggravation, and mostly without an obvious history of lumbar trauma. In most patients with lumbar spinal stenosis, pain in the lower extremities will increase after walking for a period of time, or there will be an obvious feeling of heaviness, as if the legs were filled with lead, and the symptoms will be alleviated after bending or squatting to rest for a period of time, and walking can continue. However, with the aggravation of the disease, the walking distance becomes shorter and shorter, but the patient may not be affected when riding a bicycle or bending over, which is because the lumbar spine in a bent state can relieve the compression and friction of the narrow spinal canal on the spinal cord and nerves. There are also some patients who have lumbar and leg pain that worsens at night in the bed rest state. These lumbar and leg pain characteristics can be used to identify lumbar disc herniation from lumbar spinal stenosis. Treatment of lumbar spinal stenosis Lumbar spinal stenosis is a chronic disease that generally does not require emergency treatment, and in many patients, a delay of 1 to 2 years in surgery for various reasons after diagnosis does not significantly affect the outcome of surgery. Patients with lumbar spinal stenosis can be considered for surgery when they develop moderate symptoms. The purpose of surgery is to expand the spinal canal to decompress it. Simple spinal decompression surgery is very safe and in most cases does not require internal fixation devices such as steel rods and screws to supplement the fixation of the lumbar spine. However, if the lumbar spine degeneration is severe, or if it is accompanied by lumbar spine slippage, etc., internal fixation is required. The application of internal fixation makes the surgery more difficult, but the surgery is still safe for the patient when performed by an experienced surgeon. The main measure of conservative treatment is functional exercise of the lumbar back muscles to strengthen the stability of the lumbar spine and relieve pain. In life, patients will unconsciously keep their lumbar region in a forward bending position. This position can relieve lumbar pain, but over time it can cause strain on the lumbar back muscles and new pain, which needs attention. Cycling and swimming are generally not restricted. Sealing therapy is effective, physiotherapy can also be used, and aspirin-based pain medication can be used. For patients with heavy lumbar pain, poor physical condition, unable to tolerate surgery, and with stomach problems that prevent long-term use of aspirin-based drugs, transcutaneous electrical stimulation can be tried for pain relief. Since lumbar stenosis manifests itself as a chronic course, the principle of conservative treatment is symptomatic and the long-term efficacy is less than ideal. The patient’s psychological state and tolerance of pain are also related to the outcome of treatment. We often see patients with severe lumbar spinal stenosis who never stop working, while some patients with less severe disease are both stressed and in pain. Therefore, patients should actively make psychological adjustments and treat this chronic disease of lumbar spinal stenosis correctly, which is also a key factor in obtaining efficacy in treatment. Surgical treatment is suitable for patients with moderate symptoms and above with good results.