Table of ContentsView AllTable of ContentsCausesSymptomsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Causes
Symptoms
Diagnosis
Treatment
Lateral recessstenosis(LRS) is the narrowing of the space within thespinal canalthat is located toward the sides. Called the lateral recess, or Lee’s entrance, this passageway for nerves is close to thespinal nerve root.
As this type of spinal stenosis worsens, the nerve structures in the lateral recess have less and less clear space around them. Nerves may come in contact with bone, putting pressure on disc material or other tissue, which can cause pain and other symptoms.
Medical Art Inc / Collection:E+ / Getty Images
Lateral Recess Stenosis Causes
Lateral recess spinal stenosis is also known asforaminalstenosis. That’s because the condition occurs when one or more of the intervertebral foramen narrows and compresses or pinches the nerve roots within it.
This is called encroachment or impingement. Whenencroachmentoccurs, it may cause pronounced pain and other symptoms.
Symptoms of Lateral Recess Stenosis
Lateral recess spinal stenosis symptoms may include:
In some cases, more serious symptoms that disrupt bowel or bladder may occur, as well.
Because the lateral recess is part of the spinal canal, when stenosis develops there, it is categorized as central canal stenosis. In this case,myelopathysymptoms may ensue. Myelopathy symptoms result from irritation or compression of the spinal cord.
As an example, the development of lateral recess stenosis may occur when age-related changes in theligamentum flavumoccur. Such changes may include thickening, loss of strength, and loss of elasticity to the point where a buckling toward the inside of the spinal canal occurs.
A thickened ligamentum flavum creates a narrower spinal canal—the hallmark sign of central canal stenosis. If the buckling impinges on the spinal cord, it may cause myelopathy symptoms.
Is Lateral Recess Stenosis Painful?Lateral recess stenosis causes pain that gradually increases over time. There may also be burning pain that radiates into the buttocks and down the legs (sciatica), numbness or weakness in the legs, and loss of sensation in the feet. Some people experience more pain during rest and at night.
Is Lateral Recess Stenosis Painful?
Lateral recess stenosis causes pain that gradually increases over time. There may also be burning pain that radiates into the buttocks and down the legs (sciatica), numbness or weakness in the legs, and loss of sensation in the feet. Some people experience more pain during rest and at night.
Diagnosis of Lateral Recess Stenosis
Diagnosis for lateral spinal stenosis begins with aphysical examination, in which your healthcare provider will test your reflexes and look for signs of pain, weakness, and loss of sensation.
Should your provider suspect a spinal abnormality, they may order anX-ray of your spine. The X-ray will show if there are bone growths (spurs) that are pushing on your spinal canal or causing it to narrow.
To help your provider confirm their diagnosis, they will likely ordermagnetic resonance imaging(MRI), or acomputed tomography scan(CT scan). These imaging tests will give them a more detailed look at your spinal canal and nerves.
The combination of a physical exam and imaging tests is often sufficient to make a diagnosis. Sometimes, a healthcare provider will order other studies to confirm their diagnosis, including:
Treatment for Lateral Recess Stenosis
There is no cure for lateral recess spinal stenosis, nor can the condition be slowed. However, there are lateral stenosis recess treatments and therapies that can help relieve symptoms.
The goals of treatment include:
A provider also may recommend lifestyle changes, such as nutrition and stress management education.
While there is no cure for lateral recess stenosis, treatments and therapies can help relieve symptoms. These include physical therapy to improve movement and flexibility and cortisone injections to ease pain and inflammation. If symptoms do not respond to nonsurgical treatments, a surgery calledlaminectomycan be done to take pressure off of spinal nerves.
What to Expect From a Laminectomy Procedure
Medications
For people who do present with pain, healthcare providers can prescribe medications, including:
Steroid Injections
Corticosteroid injectionswill not fix the spinal stenosis but can be given to ease pain and inflammation. The steroid medication may be injected into the neck, mid-back, or lower back/buttocks, depending on where the pain is centered.
Often, steroid injections may be used with other interventions as part of an overall treatment plan.
Physical Therapy
In an effort to avoid pain, some people with lateral recess avoid physical activity. Doing so does not actually help with symptoms, though, as the lack of activity only tends to increase weakness, and subsequently, pain.
Physical therapy is therefore recommended for any person with lateral recess spinal stenosis, regardless of the severity of their symptoms. Your physical therapist will work with you to maintain and improve strength and mobility in a safe way with lateral stenosis recess exercises and stretches.
For example, you may learn how to modify exercises done in a standing position, which can increase pressure on your compressed spinal nerve(s). Instead, your physical therapist will show you how to stretch while lying down.
Physical therapy will also help you improve your balance to protect you from falling and improve the stability of your spine.
What to Expect from Spinal Stenosis Physical Therapy
Surgery
The main surgical option for foraminal stenosis isforaminotomy: The area around the affected bone in your spinal column is enlarged to make space for the compressed nerves and take pressure off of them.
For this procedure, a surgeon will make an incision in your back or neck to expose the affected vertebrae. They will then widen the intravertebral foramen and remove any blockages that are compressing nerves.
As with any invasive surgery, foraminotomy comes with risks, including infection, blood loss, stroke, and complications with anesthesia. Although rare, the procedure can also result in additional nerve damage and damage to the spinal cord.
Summary
Lateral recess spinal stenosis, also called foraminal stenosis, can cause lower back pain, weakness in the arm or leg on one side of the body, and in some cases, more serious symptoms involving bladder or bowel control. It occurs when changes in the spinal structure have impacts on nerves that run through the narrow passages of the lateral recess portion of the spinal canal.
In most cases, a physical exam along with imaging can support a diagnosis. Depending on the severity, your healthcare provider may take a wait-and-see approach or recommend over-the-counter pain relievers. Prescription drugs, steroid injections, physical therapy, and surgery may be necessary.
A Guide to Managing Cervical Spinal Stenosis
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Association of Neurological Surgeons.Lumbar spinal stenosis.
Lv Z, Jin L, Wang K, Chen Z, Li F, Zhang Y,et al.Comparison of Effects of PELD and Fenestration in the Treatment of Geriatric Lumbar Lateral Recess Stenosis.Clin Interv Aging. 2019 Dec 16;14:2187-2194. doi:10.2147/CIA.S226295.
Chelladurai A, Balasubramaniam S, Anbazhagan SP, Gnanasihamani S, Ramaswami S.Dorsal Spinal Ligamentum Flavum Thickening: A Magnetic Resonance Imaging Study.Asian Spine J. 2018;12(1):47–51. doi:10.4184/asj.2018.12.1.47
Johns Hopkins Medicine.Lumbar spinal stenosis.
Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE,et al.Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical Practice Guideline.J Pain. 2021 Sep;22(9):1015-1039. doi: 10.1016/j.jpain.2021.03.147.
Suzuki A, Nakamura H.Microendoscopic Lumbar Posterior Decompression Surgery for Lumbar Spinal Stenosis: Literature Review.Medicina (Kaunas). 2022 Mar 4;58(3):384. doi:10.3390/medicina58030384.
Manchikanti L, Benyamin RM, Falco FJ, Kaye AD, Hirsch JA.Do Epidural Injections Provide Short- and Long-term Relief for Lumbar Disc Herniation? A Systematic Review.Clin Orthop Relat Res. 2015;473(6):1940-56. doi:10.1007/s11999-014-3490-4
Cedars Sinai.Foraminal stenosis.
Johns Hopkins Medicine.Foraminotomy.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
