Knowing the Signs Can Help You Get the Right Treatment 

By Christopher Lucasti, MD 

Back and neck problems become increasingly common as we age, but pain isn’t always the only sign that something is wrong. Changes in walking, balance, strength, sensation, or even hand function can sometimes indicate pressure on the spinal cord or nerves. 

Some of the conditions I commonly see include lumbar spinal stenosis, cervical spinal stenosis, degenerative cervical myelopathy, and spondylolisthesis. Understanding their symptoms can help people know when to seek an evaluation. 

Lumbar spinal stenosis

 occurs when the spinal canal in the lower back narrows, putting pressure on the nerves. Symptoms may include lower back pain; burning, aching, numbness, or tingling in the buttocks or legs; and leg weakness. A common clue is discomfort that worsens with standing or walking and improves when sitting or leaning forward. 

Cervical spinal stenosis

 involves narrowing of the spinal canal in the neck. When this narrowing compresses the spinal cord, it can cause degenerative cervical myelopathy, a condition that warrants particular attention. Symptoms can include numbness or weakness in the hands or arms, difficulty with fine motor tasks such as buttoning a shirt or writing, problems with balance and coordination, and changes in walking. Some people notice they drop objects more often or that their hands don’t work as well as they once did. 

Spondylolisthesis

 occurs when one vertebra slips forward relative to another. It often affects the lower back and can cause back pain, leg pain, numbness, tingling, or weakness. Symptoms may worsen with prolonged standing or walking and improve with sitting or bending forward. 

The good news is that having one of these conditions does not necessarily require surgery. Whenever appropriate, I recommend starting with conservative treatments, such as physical therapy, anti-inflammatory medications, and injections. The goal is always to find the least invasive treatment that safely and effectively relieves symptoms. 

However, when conservative measures don’t provide sufficient relief, or when spinal cord or nerve compression is causing progressive neurologic deficits, surgery may be appropriate. Advances in minimally invasive and endoscopic spine surgery are enabling us to treat many conditions through smaller incisions, with less disruption of surrounding tissues and, for appropriately selected patients, a smoother recovery. 

When needed, surgery can make a real difference. For someone whose ability to walk, work, sleep, exercise, or perform everyday activities has been limited by a spinal condition, successful treatment can be life-changing. Persistent pain, increasing weakness or numbness, difficulty walking or maintaining balance, or changes in hand coordination shouldn’t be dismissed as part of getting older. An evaluation can help determine the cause of these symptoms and which treatment options make the most sense.  

Christopher Lucasti, MD, is an orthopedic spine surgeon with UBMD Orthopaedics & Sports Medicine. He sees patients at the 716 Health Complex, 111 North Maplemere Road, Williamsville, for neck and back pain, spinal deformities, traumatic spinal injuries, and other spinal conditions. To schedule an appointment with Dr. Lucasti, call 716-204-3200 or visit www.UBOrtho.com.