Spinal stenosis: what is it, and what causes flare ups?

Written by: Mr Robert Lovell
Edited by: Conor Lynch

Top Doctors recently spoke to highly skilled and experienced Ipswich-based consultant spinal surgeon, Mr Robert Lovell, to discuss what conditions may lead to spinal stenosis, and what the most common causes of spinal stenosis flare ups are.

Which conditions may cause spinal stenosis?

Spinal stenosis is a common feature of the spine going through the ageing process. It is not usually caused by any specific condition. More often than not, it is not something anyone has caused or could have avoided.


As the spine ages, joints become worn and overgrow (a bit like knobbly finger joints). This can narrow the space available for the nerves. This is called stenosis.


What is a common issue for patients with spinal stenosis?

Patients will often complain of pain, numbness, or pins and needles in the legs. They may complain that the legs feel dead or heavy when walking or standing, and they will find that they need to sit or bend forward frequently. Stenosis may also occur in the neck, leading to similar problems affecting the arms and hands.


What causes spinal stenosis to flare up?

Flare ups may be caused by muscle spasms, which can be caused by bending or twisting suddenly. They may be caused by an additional problem such as a slipped disc. Some patients may just reach a tipping point where their stenosis becomes symptomatic without any identifiable cause or event.


What are the treatment options available?

In the first instance, simple over-the-counter painkillers may be all that is required. Advice from a GP or pharmacist is very useful. If symptoms fail to settle, a physiotherapist or osteopath will often be able to help with strengthening and postural exercises. They will be able to work into any tight or knotty muscle and help with pain.


If things don’t settle, a scan may be required to see exactly what is going on. Options from that point may include targeted physical treatment or intervention. Often, injections are all that are required to calm things down. These are usually undertaken in theatre under sedation as a day-case procedure. Sometimes, however, a discussion regarding the pros and cons of surgery is called for.


Can exercise or physical therapy help?

Yes. Almost always there is a benefit in seeing a physio or osteopath.


Does spinal stenosis require fusion?

No. Whilst some patients do come to surgical treatment, the majority of these do not need fusion. Most of the time, surgery involves cutting away the overgrown joint or thick ligament to relieve pressure on the nerves. There are some cases where fusion is required, but only in specific circumstances such as where one of the bones has moved forward on top of the one below (spondylolisthesis).


To book a consultation with Mr Robert Lovell, simply head on over and visit his Top Doctors profile today.

By Mr Robert Lovell
Orthopaedic surgery

Mr Robert Lovell is a highly esteemed consultant spinal surgeon based in Ipswich who specialises in the diagnosis and management of back pain, sciatica and spinal stenosis with non-operative treatments and surgical procedures, including discectomy, decompression, spinal fusion and spinal injections. His particular sub-speciality interest is cervical surgery and he also has extensive experience in cervical disc replacement.

Mr Lovell qualified from University College London Medical School in 1998 and completed his basic surgical training at University College Hospital, St Mary’s and The Royal National Orthopaedic Hospital, Stanmore. Following this, he joined the East Anglian Higher Surgical Training Programme in Trauma and Orthopaedics, where he specialised in spinal surgery. After receiving his Fellowship of The Royal College of Surgeons, Mr Lovell travelled to Australia to accomplish the prestigious AO year-long Spinal fellowship in Brisbane. He was then appointed as a consultant in spinal surgery at The Ipswich Hospital in 2010. 

Alongside his highly-sought spinal surgery practice, Mr Lovell regularly carries out spinal medico-legal and clinical negligence work. He has an interest in medical education and performs frequent international lectures on all aspects of spinal surgery for trainee surgeons, senior colleagues and patient groups.

Mr Lovell currently consults privately at Gilmour Piper as part of the multi-disciplinary team. They hold a weekly meeting to discuss complex cases and plan individualised treatment tailored to patients’ particular problems. Mr Lovell has an established practice of spinal surgery under regional anaesthesia, which involves anaesthetic techniques similar to those used in caesarean sections, to reduce post-operative pain and enhance recovery. This is attracting patients from around the country who can benefit from his expertise.

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