Low back pain from stenosis and spondylosis

Spinal stenosis and spondylosis refer to two conditions that are very similar and arise from chronic degenerative conditions of the spine, Dr Tow says. “The spine is a series of bones with joints in between. In the front we have the cartilage, which is a shock absorber for the spine and at the back we have the facet joints, which allow the bones to move up and down and prevent translation of the bone."

Inside the spine exists the nerves and these nerves come out at every level of the spinal cord and lead all the way up to the brain. The spinal cord and the nerves are in charge of sensation and control of the lower limbs. When we have conditions arising from the spine, for example, when there is protrusion of the disc, or when there is degeneration of the joints in the spine, like arthritis of the facet joint or bulging of the cartilage, it results in pain, numbness, and weakness of the lower limbs.

A degenerative condition of the spine can result in the patient experiencing back pain, but when there is protrusion of the cartilage or formation of bone spurs, this can result in compression of the nerves of the spinal cord. The patient may experience weakness, numbness, and tiredness in the lower limbs because the nerve supply to those limbs is affected.

Patients with lumbar spondylosis will generally have a chronic degree of back pain, especially when performing activities, and with time when the condition becomes more severe they will start having buttock pain, thigh pain, and calf pain. Pain in these areas is a sign that there is nerve irritation or nerve impingement and often it affects one side more than the other.

A typical patient with lumbar spondylosis and spinal stenosis will complain of low-grade chronic back pain that has been around for many years. They will also experience recent onset pain in the buttock that spreads down the thigh and leg and is associated with numbness, tingling sensations, and difficulty in walking for long periods. They may also complain that after walking a certain distance they feel their leg is very tired and they need to sit down and rest, find a position of comfort or they will need to lean on a certain object to get relief. In addition, they may start walking with a list, listing to one side or hunching forward to create more space for the nerve, which is being pinched.

Dr Benjamin Tow is a consultant orthopeadic and spine surgeon, with extensive experience in treating degenerative conditions of the spine, deformity-surgery and minimally-invasive spine surgery, as well as treating general orthopaedic conditions in children and adults. He is in private practice at The Orthopaedic and Spine Clinic in Singapore and can be contacted at +65 6235 5774.