[Hinews] [Physician's Column] By Dr. Kyungwoo Park, Director of Kwanghye Spine Hospital.

Lower back pain is a frequent complaint among middle-aged and older adults, often brushed off as an unavoidable part of aging. Many reach for over-the-counter pain relievers or heating patches, chalking up their discomfort to a weekend of overexertion or poor posture. Yet this dismissive approach can obscure serious conditions. Spinal stenosis, nearly as common as herniated discs in older populations, can severely diminish mobility and quality of life if not addressed early.

The spine, the body’s central pillar, begins to show degenerative changes as early as one’s 20s. Over decades, the discs, ligaments, and joints that support the spine gradually weaken, leaving it vulnerable to disorders. Because this deterioration unfolds slowly, its severity often goes unnoticed until pain becomes persistent. While herniated discs are commonly suspected, misdiagnosis is frequent, and many patients fail to receive proper care. The recent rise in spinal stenosis diagnoses highlights this oversight.

Spinal stenosis occurs when the spinal canal, intervertebral foramina, or nerve root canals—pathways for nerves, autonomic nerves, and blood vessels—narrow, compressing these structures and causing neurological symptoms. The intervertebral foramen, a critical passage for nerve branches and blood vessels, is especially significant. When constricted, it can trigger not only pain but also numbness, tingling, and muscle weakness.

Dr. Kyungwoo Park, Director of Kwanghye Spine Hospital, emphasizes the importance of early diagnosis and treatment for spinal stenosis to maintain quality of life.
Dr. Kyungwoo Park, Director of Kwanghye Spine Hospital, emphasizes the importance of early diagnosis and treatment for spinal stenosis to maintain quality of life.

Symptoms of spinal stenosis extend beyond typical back pain. Patients often report sharp or crushing sensations radiating to the hips or buttocks, with pain sometimes spreading to the calves and toes. A defining feature is neurogenic claudication—leg pain during walking that feels as though the legs might “give out,” forcing the individual to stop and rest. Initially, short walks may be tolerable, but as the condition worsens, the distance one can walk shrinks, and some avoid leaving home altogether. In severe cases, symptoms can progress to leg numbness, bladder or bowel dysfunction, or partial paralysis of the lower body.

Because spinal stenosis develops gradually through years of degenerative changes, it is often mistaken for routine back pain until it becomes advanced. By the time symptoms are debilitating, conservative treatments—such as medications, physical therapy, or epidural injections—may no longer suffice, necessitating more invasive measures.

Foraminoplasty is one effective intervention. This procedure widens the narrowed intervertebral foramen to relieve pressure on compressed nerves and blood vessels. Performed under local anesthesia in about 30 minutes, it is suitable for elderly patients or those with chronic conditions. A small incision is made in the flank, through which a specialized catheter is inserted to remove thickened ligament tissue, inflamed material, or other obstructions. This alleviates nerve compression, reduces pain, and promotes functional recovery. However, treatment decisions should not rely solely on symptoms. Consultation with experienced spine specialists, supported by objective diagnostic tests like imaging studies, is crucial for determining the best approach.

Preventing spinal stenosis requires consistent lifestyle habits. Low-impact aerobic exercises, such as swimming or walking, strengthen back muscles without straining the spine. Those who sit for long periods should stand and stretch hourly to relieve muscle tension and reduce the risk of spinal issues.

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