Factors Contributing to Disability in Lumbar Spinal StenosisLumbar spinal stenosis can be a very disabling condition. The spinal canal narrows and pressure on the spinal nerves can cause significant back and/or leg pain. Spinal extension or even just standing up straight can become very painful.
What are the factors leading to disability in this condition? The authors of this study hope by finding out, steps can be taken earlier to prevent disability. Patients usually think pain is the major limiting factor. But studies don't bear this out. Pain intensity is only a portion of the problem.
In this study the Oswestry Disability Index (ODI) was used to measure how pain affects activities of daily living. The ODI is a survey with questions that help measure disability. Other tests and measures conducted included pain intensity, muscle strength, spinal flexibility, and vibration sense.
The authors report the biggest factor in disability associated with lumbar spinal stenosis was the location of the patient's symptoms. Patients who had pain in the low back and leg were more likely to be disabled compared to patients who only had back pain.
Pain intensity and a loss of vibration sense added to the problem. Disability was much more likely for patients with all three factors plus muscle weakness. Age was not a factor. Younger adults with these risk factors could be more disabled than older adults with fewer risk factors.
The results of this study support the idea that symptoms are not necessarily greater when more spinal levels are involved. Symptom location and intensity are the main factors of disability. Vibration sense and muscle weakness are added factors toward disability.
Sang-I Lin, PhD, PT, et al. Disability in Patients with Degenerative Lumbar Spinal Stenosis. In Archives of Physical Medicine and Rehabilitation. September 2006. Vol. 87. No. 9. Pp. 1250-1256.
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