The L5-S1 disc, located between the L5 vertebra and the first bony segment at the top of the sacrum, is essential for all spinal movement. Pain is sometimes described as dull ache or tenderness to electric-like or burning sensation. If the cross section is 76 mm2 to 100 mm2, the spinal canal is stenotic but not completely so. If the antero-posterior diameter is less than 18.4 inches (45.1 cm), the spinal canal may be stenotic. If you are experiencing back pain without any symptoms other than the usual mild discomfort, your doctor may order an MRI or spinal tap. (https://www.spine.org/KnowYourBack/Conditions/Degenerative-Conditions/Cervical-Stenosis-Myelopathy-and-Radiculopathy), (https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Spinal-Stenosis), (https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Lumbar-Spinal-Stenosis), (https://www.merckmanuals.com/home/quick-facts-brain,-spinal-cord,-and-nerve-disorders/spinal-cord-disorders/spinal-cord-compression?query=spinal%20cord%20compression), (https://www.statpearls.com/as/musculoskeletal/29356/), Visitation, mask requirements and COVID-19 information, Nonsteroidal anti-inflammatory medications. Last medically reviewed on December 21, 2021, The back is a sensitive part of the body, which has many nerves and organs nearby. Does spinal stenosis cause bowel incontinence? Spinal stenosis, a narrowing of the spaces in your spine, can compress your spinal cord and nerve roots exiting each vertebrae. If the symptoms are severe or persist beyond a few weeks, a person should contact a doctor. The signal sent from the stretch receptors in the wall of the anus will cause the cerebrum to open when the rectum fills up. It is completely surrounded by the bony parts of the spine. The vertebrae are held together with screws, rods, hooks or wires until the vertebrae heal and grow together. Policy. It makes the space within the spinal canal bigger by creating a hinge on the lamina. Despite the fact that there is no one-size-fits-all solution when it comes to how you walk, you can take some steps to help. A healthcare professional may recommend the following to treat the causes of lower back pain and constipation. Last reviewed by a Cleveland Clinic medical professional on 08/17/2020. If you are experiencing any of these symptoms, it is important to see a doctor for a proper diagnosis. In: Current Diagnosis & Treatment: Physical Medicine & Rehabilitation. Surgery results depend on your general health and presence of other medical conditions, severity and location of your spinal stenosis, experience and skills of your surgeon and your commitment to your recovery plan. Spinal stenosis is the narrowing of one or more spaces within your spine. Numbness or tingling (pins and needles) in the buttocks, leg or foot. There is no cure for this condition, but there are steps you can take to alleviate your symptoms. Medical News Today only shows you brands and products that we stand behind. Know what to expect if you do not take the medicine or have the test or procedure. Accessed Oct. 31, 2022. As a result of an injury that exceeds T11/T12, the muscles of the sphinx and pelvic floor may become strained. Follows a fall, blow to the back or other injury. If you have lumbar spinal stenosis, you may be unable to walk or may need to lean forward to relieve lower back pressure. The healing process takes six months to one year. In some cases, it can also affect bowel movements. That's why most people who develop symptoms of spinal stenosis are 50 or older. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Learn more about constipation and its causes here. The muscle or nerve damage may be associated with aging or with giving birth. Age-related changes in your spine is a common cause. Ankylosing spondylosis can cause the vertebrae to fuse, which is an inflammatory condition. Signs and symptoms of neurogenic bladder may include: Loss of bladder control Inability to empty the bladder Urinary frequency Urinary tract infections. But some people's symptoms stay the same or get worse after Long-lasting constipation. When is that pain hep-b related and when is it something else? Balancing is a challenge. This article examines whether lower back pain can cause constipation. In most cases, these operations help reduce spinal stenosis symptoms. People with multiple sclerosis or spina bifida might have similar problems. (n.d.). Stretches can be used to keep muscle stiffness at bay. A spinal spinal cord canal can form when the vertebral column narrows. Problems controlling urine or bowel movements; Exams and Tests. You may also have pain or numbness in your legs. Severely pinched nerves in certain parts of the spine can even cause loss of bowel and bladder control. Another type of fecal incontinence occurs in people who are not aware of the need to pass stool. Fortunately, most people who have spinal stenosis dont need surgery. Hazzards Geriatric Medicine and Gerontology, 7e. https://www.uptodate.com/contents/search. A variety of spinal cord injuries, herniation disks, tumors, and ankylosing spondylosis are all possible causes of digestive problems. Spinal stenosis, a narrowing of the spaces in your spine, can compress your spinal cord and nerve roots exiting each vertebrae. Laminectomy (decompression surgery): The most common type of surgery for this condition, laminectomy involves removing the lamina, which is a portion of the vertebra. Damaged nerves disrupt the ability of your rectum to store and get rid of waste. All rights reserved. Incontinence, Bowel, Elderly Patient. Symptoms include back and/or neck pain, and numbness, tingling and weakness in your arms and legs. If the spinal canals cross sectional area is less than 76 mm2, surgery may be required to repair the canals severe stenotic condition. Age-related changes in your spine is a common cause. This narrowing can put pressure on the spinal cord and nerves, leading to pain, numbness, and weakness. Cameron AM, et al. information submitted for this request. However, if a spinal nerve or the spinal cord is compressed for a long period of time, permanent numbness and/or paralysis is possible. Here are some ways to keep your spine healthy: The best way to manage lumbar spinal stenosis is to learn as much as you can about your disease, work closely with your medical team, and take an active role in your treatment. Brototo B, et al. So can rubbing with dry toilet paper. But you may be able to lower your risk. Causes new bowel or bladder problems. Soap can dry and irritate the skin. Know how you can contact your provider if you have questions. Spinal stenosis is a condition that occurs when the spaces in your spine narrow, putting pressure on the spinal cord and nerves. Mayo Clinic. It is possible to get spinal stenosis if spurs are placed near the spinal canal, pinch nerves, or narrow the canal. Some leg muscles, including the bladder and bowel external sphincters, as well as some external sphincters (particularly in men and women) that regulate sexuality and bladder function, are in the sacral spinal cord. Herniated disks and bone spurs are two common causes of spinal stenosis. It can be caused by a variety of factors, including numbness between your legs, inner thighs, and back of your legs. This condition gets in the way of your normal ability to store and get rid of waste. Metal hardware bridges the gap in the opened section of the spine. In severe cases, it can cause paralysis. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. But for some people, fecal incontinence happens a lot. Failure of the bone to heal after surgery. 2023 Brandon Orthopedics | All Right Reserved, Spinal Stenosis Is A Serious Condition That Requires Ongoing Treatment Chronic Back Pain: Spinal Stenosis, After Shoulder Arthroscopy: What To Expect, The Truth About Spinal Stenosis: Causes Symptoms And Treatments, Can Years Of Surfing Contribute To Spinal Stenosis, The Effects Of Spinal Stenosis And Carpal Tunnel, Should I Apply Ice Or Heat To A Compression Fracture, How Does A Soft Bed Prevent Healing Of Herniated Disc, Herniated Discs: How To Sleep Without Worrying About Rupturing Your Discs, If You Have A Herniated Disc You Know The Excruciating Pain It Can Cause. Lower back pain can cause a variety of issues with the stool. Gently wash the area with water after each bowel movement. It is possible for the condition to affect your urinary system and stomach. Chronic constipation may cause a dry, hard mass of stool to form in the rectum and become too large to pass. BMC Surgery. If you are experiencing any of these symptoms, you should consult with a doctor as soon as possible. Review/update the This condition, known as spinal canal narrowing, occurs when the spinal canal narrows. If the narrowing causes pressure on the nerve root it will can cause problems. Call your healthcare provider if you have: At Another Johns Hopkins Member Hospital: 5 Questions to Answer Before Considering Sciatica Surgery, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Traumatic and Non-traumatic Spinal Cord Injury, Burning pain going into the buttocks and down into the legs (sciatica), Numbness, tingling, cramping, or weakness in the legs, A weakness in a foot that causes the foot to slap down when walking ("foot drop"), Severe or increasing numbness between your legs, inner thighs, and back of the legs, Severe pain and weakness that spreads into one or both legs. Why Do Cross Country Runners Have Skinny Legs? Inflammation is caused by the presence of sympathetic and parasympathetic nerves that connect directly to the digestive system in the lower spine, and interference directly affects these nerves. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Key Considerations with Surgery for Lumbar Stenosis. Any damage to the spinal cord can interfere with the digestive systems ability to communicate with the brain. There is a problem with Sometimes, the cause of lower back pain can lead to constipation. (2019). WebA spinal cord injury or a nerve disease may damage the nerves that help control the lower part of your colon. People with this condition may not be able to stop the urge to defecate. Surgical management of fecal incontinence. The nutritional supplements glucosamine and chondroitin have been recommended as nutritional supplements for osteoarthritis, but recent studies have been disappointing. People with more severe stenosis may have problems with: Bowel function. information is beneficial, we may combine your email and website usage information with No relief of symptoms/return of symptoms. In most cases, these operations help reduce spinal stenosis symptoms. EMMY NOMINATIONS 2022: Outstanding Limited Or Anthology Series, EMMY NOMINATIONS 2022: Outstanding Lead Actress In A Comedy Series, EMMY NOMINATIONS 2022: Outstanding Supporting Actor In A Comedy Series, EMMY NOMINATIONS 2022: Outstanding Lead Actress In A Limited Or Anthology Series Or Movie, EMMY NOMINATIONS 2022: Outstanding Lead Actor In A Limited Or Anthology Series Or Movie. Part of the lamina called the spinous process is the ridge you feel when you run your hand down your back. The vagus nerve is a cranial nerve that wanders from the base of the brain parallel to the spinal cord to stimulate digestion in the liver, stomach, and intestines. Find positions that relieve your pain. For instance, manipulation may worsen symptoms or cause other injuries if a herniated disk is the cause of your spinal stenosis. Symptoms include back and/or neck pain, and numbness, tingling and weakness in your arms and legs. This can result from dietary choices, medications, and a lack of exercise, amongst other causes. It is critical to have your spine examined if you are experiencing back pain. The nerve fibers or nerves (the mini cable network) then go out to all parts of the body. Narayanan SP, et al. It makes the space within the spinal canal bigger by creating a hinge on the lamina. If you do develop symptoms, there are many options up to and including surgery that can be considered to relieve your pain and other symptoms so you feel better. If sciatic nerve damage is to blame, it is possible that serious bowel and bladder problems will occur. Anal irrigation is a novel, conservative bowel management method that assists in bowel movement and management while reducing constipation. A spinal spinal canal can cause problems in the movement and function of the spine. People with multiple sclerosis or spina bifida might have similar problems. Spinal fusion surgery permanently joins (fuses) two vertebrae together. Is accompanied by a fever. This can cause bladder and bowel dysfunction known as neurogenic bladder or neurogenic bowel. TimesMojo is a social question-and-answer website where you can get all the answers to your questions. If they suddenly occur at, Back pain and nausea can often occur at the same time and cause much discomfort. Although spinal stenosis can happen anywhere along the spinal column, the lower back (number one most common area) and neck are common areas. When we move, the digestive system is stimulated, and the peristaltic wave which moves stool through the colon is also activated. As a result, the cerebrum allows you to regulate bowel movements. If you have abdominal pain and bloating, it is very likely that you have irritable bowel syndrome. The sacral spinal cord is the lowest point in the spinal cord. The cauda equina is a group of nerve roots located at the lower end of the spinal cord. Elsevier; 2021.https://www.clinicalkey.com. But the sooner you're evaluated, the sooner you may find some relief from your symptoms. Home | About | Contact | Copyright | Report Content | Privacy | Cookie Policy | Terms & Conditions | Sitemap. Cauda equina nerves have nerve connections to the bladder, bowel, and legs, allowing for muscle sensation to flow between those parts. It often causes constipation and bowel accidents. Pain that worsens when standing for long periods of time, walking or walking downhill. Its important to go to your doctor or an emergency room immediately if the symptoms appear. Additional risks from surgery for spinal stenosis include: To prepare for spine surgery, quit smoking if you smoke and exercise on a regular basis (after checking with your healthcare provider first) to speed your recovery time. The narrowing of the spinal canal or the side canals that protect the nerves often results in a pinching of the nerve root of the spinal cord. You may also have pain or numbness in your legs. It is one of the most common causes of aging-related conditions. A variety of factors, including poor posture, smoking, being overweight, and being physically inactive, can aggravate spinal stenosis, and flare-ups can be more severe. Sacral problems are frequently overlooked in the midst of lower back pain. include protected health information. A chiropractor to manipulate your spine and related muscles, ligaments and bones. Since most causes of spinal stenosis are normal age-related wear and tear conditions, such as osteoarthritis and loss of bone and muscle mass, you cant 100% prevent spinal stenosis. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.orthoinfo.org/en/diseases--conditions/lumbar-spinal-stenosis/), (https://www.spine.org/KnowYourBack/Conditions/Degenerative-Conditions/Lumbar-Spinal-Stenosis), (https://www.niams.nih.gov/health-topics/spinal-stenosis). Definition & facts for constipation. Gently wash the area with water after each bowel movement. Stenosis, which means narrowing, can cause pressure on your spinal cord or the nerves that go from your spinal cord to your muscles. The spinal cord is a bundle of nerves that comes out of the base of the brain and runs down the center of the spine. Click here for an email preview. Multiple sclerosis. Most peoples bowel movements are carried out at their regular times of day, which allows them to maintain their health at a reasonable level. Gastroenterology Clinics of North America. Mayo Clinic. In addition to pain, numbness, and muscle weakness, some people with spinal stenosis experience walking problems. This is a more severe and a major concern as cervical stenosis can lead to extreme weakness causing paralysis. It often causes constipation and bowel accidents. Ask your provider if you need to stop taking any non-essential medications, supplements or herbal remedies that you may be taking that could react with anesthesia. Constipation and bowel problems are frequently caused by it. A laminectomy is usually performed first and bone removed during this procedure is used to create a bridge between two vertebrae, which stimulates new bone growth. pain in one or both of your legs. Interspinous spacers are inserted into the bone between two adjacent vertebrae, which is then fused. 2019; doi:10.1007/s11934-019-0909-1. What helps leg pain from spinal stenosis? As a result, pressure is applied to the nerves and spinal cord, causing back and lower body pain. Physical therapy can help you alleviate lower back pain while also assisting you in finding relief from your pain. McGraw-Hill; Accessed 8/4/2020. What type of pain does spinal stenosis cause? The lumbar spine, or lower back, includes the sacrum and is particularly vital in terms of nerve function. This is especially important if it happens a lot, is severe or causes emotional distress. The spinal cord and/or nerve roots become compressed or pinched, which causes symptoms, such as low back pain and sciatica. Constipation and bowel accidents are frequently associated with it. Nerves roots are the initial segment of a bundle of nerve fibers that come off the spinal cord and exit the spinal column through side spaces between the vertebrae called the neural foramen. Because of disrupted signals between the colon and the brain, you may not feel the urge to have a BM. When spinal stenosis causes pain, it can cause the legs to lose strength over time. You may be given a brace or corset to wear for comfort. We are vaccinating all eligible patients. Because the lower spine contains sympathetic and parasympathetic nerves, which are directly connected to the digestive system, interference directly affects these nerves. Its important to keep in mind that similar to other nonsurgical treatments, these alternative therapies dont improve the narrowing of the spinal canal. Spinal stenosis has many causes. What should I avoid with spinal stenosis? To establish that the product manufacturers addressed safety and efficacy standards, we: We do the research so you can find trusted products for your health and wellness. Examples include celiac, Back pain and incontinence can occur at the same time due to a single underlying condition, such as cauda equina syndrome. When you have a full bladder or when your bladder is emptying, your blood pressure should be checked. Diabetes. Yes, this is certainly possible. He is passionate about helping his patients achieve the best possible outcome and is committed to providing the highest quality of care. Accessed Oct. 8, 2020. Severe or increasing numbness between your legs, inner thighs, or back of your legs, Severe pain and weakness that spreads into one or both legs, making it hard to walk or get out of a chair. As a result of endometriosis, these tissues should be lining the uterus, which is found on the ovaries, fallopian tubes, and intestines. First, spinal stenosis develops slowly over time, so you may not have symptoms even though changes are occurring in your spine. Symptoms usually worsen when walking or standing and might decrease when lying down, sitting, or leaning slightly forward. Osteoporosis. Makris UE, Reid M. Back Pain and Spinal Stenosis. Brandon Callahan, MD is a board-certified orthopedic physician with a decade of experience in providing comprehensive orthopedic care to patients with musculoskeletal injuries and disorders. If you have a spinal cord injury or a nerve disease, it is possible that your spine will interfere with your ability to control your bowels. Symptoms include back and/or neck pain, and numbness, tingling and weakness in your arms and legs. Fecal incontinence is sometimes called bowel incontinence. The NIDDK recommends that a person sees a doctor right away if they have lower back pain and constipation together or experiences frequent bouts of constipation or unexplained instances of lower back pain. The following are examples of conditions that can cause both constipation and lower back pain at the same time: Learn about the differences between IBD and IBS here. Welcome to Brandon Orthopedics! In more severe cases, you may The nerves that control the bowel are located in the lower back, and if these nerves are damaged, it can cause problems with bowel function. Accessed Oct. 8, 2020. (2018). If needed, use assistive devices such as a cane or walker to safely move about. Reflex bowel problems may cause a sudden, unplanned BM when the rectum is full. Current Gastroenterology Reports. Finally, spinal stenosis can also cause pain in the lower back and legs, which can make it difficult to move the bowels. The procedure involves removing bone or tissue this area to provide more space for the nerve roots. A small drill is used to insert a doughnut-shaped spacer into the vertebrae between the vertebrae. privacy practices. Showering or soaking in a bath also may help. Cervical spinal stenosis causes pain in the neck area and is caused by the constriction of the spinal cord. 13th ed. Also, never hesitate to ask your healthcare team any questions you may have or discuss any concerns. Brandon Callahan, MD is a board-certified orthopedic physician with a decade of experience in providing comprehensive orthopedic care to patients with musculoskeletal injuries and disorders. But don't shy away from talking to your doctor about this common problem. Is the ketogenic diet right for autoimmune conditions? The spinal disks become drier and start to bulge. Constipation. Signs and symptoms of neurogenic bladder may include: There are treatment options and other ways to manage neurogenic bladder, such as: Bowel management options for people with neurogenic bowel include: The Spinal Cord Injury Rehabilitation Program at Mayo Clinic's campus in Minnesota offers several bladder and bowel management options for people with neurogenic bladder or bowel. In addition to leg pain, numbness can occur in your arms. Spinal stenosis, a narrowing of the spaces in your spine, can compress your spinal cord and nerve roots exiting each vertebrae. The spinal cord the bodys master cable cord that sends and receives messages between the body (including muscles and organs) and the brain runs through the center of the spinal canal. If you have lumbar spinal stenosis, you may have trouble walking distances or find that you need to lean forward to relieve pressure on your lower back. Simple home remedies like an ice bag, heating pad, massage, or a long, hot shower can help. Problems controlling urine or bowel movements; Exams and Tests. Walking and maintaining your balance has become difficult. An injury to the spinal cord, like that of an neurogenic bladder, has a variety of effects. If you have this condition, consult your healthcare provider to determine the cause of your loss of bowel or bladder control. Pregnancy can also cause lower back pain and constipation together. https://www.urologyhealth.org/urology-a-z/n/neurogenic-bladder. A tightened space can cause the spinal cord or nerves to become irritated, compressed or pinched, which can lead to back pain and sciatica. People with more severe stenosis may have problems with: Bowel function. Can diet help improve depression symptoms? American Academy of Orthopaedic Surgeons. Avoid movements that twist or strain the back. Spinal stenosis usually occurs as a person ages, however, some patients are born with less space for their spinal cord. If youve had a laminectomy, you will likely be able to go back to work at a desk job within a few days of returning home. The cervical, thoracic, lumbar, and sacral nerves are all part of the spinal cord. Most people who undergo spinal stenosis surgery achieve good to excellent results with pain relief. Constipation. Often, people are too embarrassed to tell a provider about fecal incontinence. If you suffer from abdominal pain and bloating, it is likely that you also suffer from irritable bowel syndrome. Showering or soaking in a bath also may help. This can cause bladder and bowel dysfunction known as neurogenic bladder or neurogenic bowel. Spinal stenosis occurs when compression in the spine causes pain, numbness, and weakness, usually in the legs. Spinal stenosis in the neck can cause: Numbness Tingling or weakness in a hand, leg, foot or arm Problems with walking and balance Neck pain Problems with the bowel or bladder Request an Appointment at Mayo Clinic From Mayo Clinic to your inbox Solid waste is transported out of the body via this passageway. Usually a patient with spinal stenosis has more pain when standing upright or walking with relief when bending forward. A pain management specialist to manage pain and discomfort. Urinary tract infections (UTIs) are caused by a variety of infections of the urinary system, including those in the kidneys, ureters, bladder, and urethra. This narrowing can put pressure on the spinal cord and nerves, leading to pain, numbness, and weakness. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Advertising revenue supports our not-for-profit mission. Spinal stenosis usually occurs as a person ages, however, some patients are born with less space for their spinal cord. A rheumatologist to treat arthritis and related disorders. To use the body SECCA procedure for anal incontinence and antibiotic treatment: A case report of anal abscess. It also looks at conditions that cause both symptoms, potential individual causes, and treatment options. This content does not have an English version. During the physical exam yourhealthcare provider will look for signs of spinal stenosis, such as loss of sensation, weakness, and abnormal reflexes. If youve had spinal fusion, you may have a three- to five-day hospital stay. health information, we will treat all of that information as protected health Spinal stenosis occurs when compression in the spine causes pain, numbness, and weakness, usually in the legs. Multiple sclerosis. There are a few ways in which spinal stenosis can affect bowel movements. Obeseness of the bowels is accompanied by abnormal bowel movements or loss of bowel control. Mayo Clinic is a not-for-profit organization. It is possible for the condition to affect your urinary system and stomach. In this procedure, only a small part of the lamina is removed the area causing the most pressure on the nerve. A physical therapist will be able to advise you on which exercises will be beneficial to you. Learn about symptoms, treatment options, and when to contact a doctor here. Your first noticeable symptoms may be pain, numbness, tingling or weakness in your back or neck or arms and legs depending on the location of the stenosis. WebSpinal stenosis, a narrowing of the spaces in your spine, can compress your spinal cord and nerve roots exiting each vertebrae. Constipation and lower back pain are two examples of bowel conditions that can cause problems. If your bowel and bladder are not controlled, it may become more difficult for you to function. Causes new bowel or bladder problems. Some ligaments and bone spurs may also be removed. If youve had a laminectomy, you may be in the hospital for a day or two. You might be able to reduce your pain and improve your walking ability with the assistance of a physical therapist. All rights reserved. Treatments can improve fecal incontinence and your quality of life. An injury above the conus medullaris (L1) results in an elevation in autonomic dysreflexia. Accessed Feb. 7, 2022. Despite the fact that spinal stenosis does not have a cure, regular exercise, medication, and surgery are all options for relieving the condition. Problems controlling urine or bowel movements; Exams and Tests. You may or may not have symptoms when spinal stenosis first develops. It may come on so suddenly that you can't make it to the toilet in time. The hypogastric nerve sends out sympathetic innervation from the L1, L2, and L3 spinal segments to the lower colon, rectum, and sphincters. A physiatrist/rehabilitation specialist to treat back pain using nonsurgical approaches. When liver disorders are present, they can also affect bowel movements. Accessed Feb. 7, 2022. Constipation and bowel accidents can occur as a result of this condition. Allscripts EPSi. The American Society of Colon & Rectal Surgeons states that growths and tumors in the colon can also cause constipation. To relieve anal discomfort and eliminate any possible odor associated with fecal incontinence: Wash with water. A single copy of these materials may be reprinted for noncommercial personal use only. Current Urology Reports. Spinal stenosis occurs when compression in the spine causes pain, numbness, and weakness, usually in the legs. Laminotomy: This is a partial laminectomy. What is the latest research on the form of cancer Jimmy Carter has? If left untreated, spinal stenosis in the lower back can cause severe pain and disability. WebIf you have lumbar spinal stenosis, you may have trouble walking distances or find that you need to lean forward to relieve pressure on your lower back. Know the reason for your visit and what you want to happen.