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Neurology (Expert Forum)
Conservative Management of Spinal Stenosis
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Conservative Management of Spinal Stenosis
by Alorac Jones, Nov 05, 1999 12:00AM
How can I find a physician with expertise in conservative management of lumbar spinal stenosis? I have consulted several spine surgeons, all of whom (of course) have suggested surgery to help my problem of bilateral paresthesia in the feet and ankles when standing or walking erect. I experience NO PAIN. Symptoms are completely relieved by bending forward, sitting, or lying down. I can walk or stand erect only for 5-8 minutes before the onset of tingling and numbness beginning in both feet. On the other hand, I can walk indefinitely using a short cane which allows me to walk bending forward. I can also walk by leaning forward on a shopping cart or walker. MRI shows degenerative stenosis at L4-L5.
I am seeking alternatives to surgery. Are there any?
I am seeking alternatives to surgery. Are there any?
Doctor's Answer
by CCF Neuro[P] MD, RPS, Nov 05, 1999 12:00AM
Dear Mr. Jones:
Not having seen your MRI showing the canal stenosis it is difficult for me to give an accurate opinion. I guess the initial question that must be asked, is the degeneration idopathic (no known reason) or is it due to a degenerative process such as arthritis, diabetes, collagen vascular disorders etc? If there is a progress etiology then the problem will definitely get worse. Surgery in that case would be the correct course. If the etiology is unknown, the degeneration is only at the spinal level mentioned, you are in otherwise good health, fit, correct weight, non-smoking, non-drinking, non-physical jobor career, then you might have an option of waiting. But, I think that I would seek opinions from other medical personal. This would include rehab physicians and especially neurology. Weight the fact, concerns and probabilities from what you gather and make an informed decision.
Sincerely,
CCF Neuro MD
Not having seen your MRI showing the canal stenosis it is difficult for me to give an accurate opinion. I guess the initial question that must be asked, is the degeneration idopathic (no known reason) or is it due to a degenerative process such as arthritis, diabetes, collagen vascular disorders etc? If there is a progress etiology then the problem will definitely get worse. Surgery in that case would be the correct course. If the etiology is unknown, the degeneration is only at the spinal level mentioned, you are in otherwise good health, fit, correct weight, non-smoking, non-drinking, non-physical jobor career, then you might have an option of waiting. But, I think that I would seek opinions from other medical personal. This would include rehab physicians and especially neurology. Weight the fact, concerns and probabilities from what you gather and make an informed decision.
Sincerely,
CCF Neuro MD
Have you gone to see a Chiropractor?
First see a neurologist, get another opinion from a neurosurgeon and then make up your mind who to see next.
Sincerely,
CCF Neuro MD
Could this herniation be causing my right symptoms because of the stenosis?
Peter Youngs
***@****
The disc herniation on the right would likely not cause your left sided symptoms. The odds are that it is your spinal stenosis.
CCF Neuro MD