Understanding back and leg pain as we age

By Dr. William Miller | May 27, 2014
Dr. William Miller

As people age, they tend to experience discomfort in their backs and legs. Why is this?

The vertebrae are the bones that make up the spine. There are 32 vertebrae, and each level has joints to allow movement. As we age, these joints, just like in fingers and knees, get bigger.  This enlargement of our joints combines with disc bulging from the front of the spine. When our joints and discs get bigger, this creates less space for our spinal cord and nerves. The result is what is known as spinal stenosis, which is a narrowing of the spinal canal.

The symptoms of spinal stenosis may include pain or numbness in your back and/or legs, or cramping in your legs. Weakness in your legs may also occur. Only rarely would you experience bowel and/or bladder problems.
Symptoms are often worse with prolonged standing or walking. Symptoms may come and go and may vary in severity. Bending forward or sitting increases room in the spinal canal and may lead to reduced pain or complete relief from pain.

Initial treatment for spinal stenosis includes physical therapy, anti-inflammatory medications (such as ibruprofen), spinal injections and activity modifications. Unless you experience a reduction in normal daily activities or you develop leg weakness, or bowel or bladder problems, the presence of spinal stenosis by itself usually does not represent a dangerous condition. Therefore, treatment is aimed at reducing pain reduction and an increase in the patient's ability to function. Nonsurgical treatments do not correct the spinal canal narrowing of spinal stenosis itself, but may provide long-lasting pain control and improved daily activities without requiring more invasive treatment.

A comprehensive program may require three or more months of supervised treatment. 
Surgery is reserved for that small percentage of patients whose pain cannot be relieved by nonsurgical treatment methods. Surgery will also be advised for those individuals who develop leg weakness that gets worse over time, a reduction in normal daily activities, or bowel and bladder problems.

Because spinal stenosis is a narrowing of the bony canal, the goal of the surgery is to open up the bony canal to improve available space for the nerves. This is called lumbar decompression surgery, or laminectomy. Surgery, when necessary, will relieve the leg pain and back pain.  Patients are allowed to return to most activities within weeks. 

Postoperative rehabilitation (rehabilitation after surgery) may be advised to assist in return to normal activities.

Dr. Jeffrey Albea is giving a seminar at 6 p.m. Tuesday, June 10, at the Health & Fitness Center classrooms. To register, call Katherine at 452-8883.

Dr. William Miller is an orthopedic surgeon who practices at Mountain Spine in Clyde.