Presentation, Diagnosis, and Management of Lower Back Pain Associated with Spinal Stenosis: A Narrative Review

23 February 2023 : Review article

Dawid Sobański^12ADEF*, Rafał Staszkiewicz^13ADEF, Magdalena Stachura^24EF, Marcin Gadzieliński^3EF, Beniamin Oskar Grabarek^13AEF

DOI: 10.12659/MSM.939237

Med Sci Monit 2023; 29:e939237

Background Causes of Pain Syndromes of the Lumbar Spine General Characteristics of Degenerative Stenosis of the Lumbar Region of the Spine Pathomechanism of Pain Syndromes of the Spine Clinical Symptoms for Patients with Stenosis of the Lumbar Region of the Spine Differentiation in Degenerative Stenosis of the Lumbar Spine Radiological Diagnosis of Patients with Degenerative Lumbar Stenosis of the Spine Pharmacotherapy, Rehabilitation, and Surgical Treatment of Patients with Degenerative Lumbar Spine Stenosis Rehabilitation Treatment of Patients with Degenerative Lumbar Spine Stenosis Future Directions Conclusions References

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Table 1 Causes of pain in the lumbar region of the spine.

Causes	Examples
Degenerative disease	Degenerative disc disease; degenerative vertebral body disease causing pressure on the nerve roots; degenerative disease in the intervertebral joints
Inflammatory changes	Ankylosing spondylitis; rheumatoid arthritis; infections (tuberculosis, brucellosis, typhuses, staphylococcus, fungal infections); other infectious spondylopathies
Cancers	Primary bone cancers (plasmocytoma, osteoma, chondro-osteoma); cancers of the nervous system (glioma, fibroma molluscum, meningioma); metastases from the breast gland, prostate gland, lungs, and kidneys)
Metabolic diseases	Osteoporosis; osteomalacia; Paget’s disease; calcium pyrophosphate deposition; ochronosis; hyperactivity of the parathyroid glands
Injuries	Acute and chronic overloads; intervertebral joint subluxation; spondyloses; vertebral body compression fractures; transverse process fractures of the lumbar vertebrae
Other congenital and acquired disorders of the statics of the spine	Lordoses and kyphoses; scoliosis; spondylolistheses; L5 sacralization; S1 lumbarization; cleft spine
Diseases outside the spine causing pain in the area of the L-S spine	Pain in the lumbar region of the spine caused by a duodenal ulcer, diseases (especially cancers) of the pancreas, kidneys, lymph nodes, abdominal cavity, shingles, thoracic aortic aneurysm; pain in the sacral region due to: diseases (especially cancers) of the uterus, rectum, prostate gland, ovaries, and pelvic lymph nodes

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