Tired Heavy Legs Could Be Spinal Stenosis November 4, 2009

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If you or someone you know is having trouble with tired, heavy-feeling legs, the problems may be related to your spinal nerves and not your stamina. Many Central Texans suffer from spinal stenosis, more commonly described as narrowing of the space around the spinal cord, often due to arthritis.

"Spinal stenosis can be related to aging," says spine surgeon Ryan K. Bergeson, MD, a spine specialist who recently moved to the Williamson County area. "Like knees and other body parts, many people have arthritis in the joints of the spine. They can have pain in the lower back but sometimes symptoms are less specific. Other symptoms can include cramping, pain and sensory changes in the legs or having the legs become tired and heavy feeling when you walk."

The result is neurogenic claudication which essentially means squeezing nerves. The spinal column contains not only the spinal cord but, in the low back, the nerve roots responsible for carrying messages into the lower extremities to enable us to move. If the space for the nerves narrows due to arthritic build-up, the pressure increases, resulting in symptoms. The condition can be confused with vascular claudication, a condition resulting from restricted blood flow to the legs that produces similar symptoms. Smokers often suffer from vascular problems.

"A few simple ways to tell the difference between the two are describable. With vascular claudication, once the legs get tired and weak, the person has to stop walking, but can continue to stand while resting. With neurogenic claudication, the person has to sit down," adds Dr. Bergeson. "When you sit down, you flex the spine which increases the area for the nerve roots to be in. That relieves the pressure, so you feel better. Bending over also helps and we often see people who lean over while walking with their walker, cane or even a shopping cart."

Spinal stenosis is progressive, so arthritis continues to develop, but there are many treatments that can help address discomfort.

"Treatment is intended to help make discomfort manageable and to let people return to an acceptable quality of life," continues Dr. Bergeson. "There are several non-surgical ways to treat the condition before someone may need to have surgery, including anti-inflammatory medications, physical therapy and steroid injections into the space around the nerves. Surgery is an option if pain and discomfort get worse and the individual begins having difficulty getting around."

He believes in physical conditioning in general because it increases blood flow, helps muscles become better equipped to hold up and support the spine and sends endorphins, nature's mood elevators, to the brain. As Central Texans live longer, more can reasonably be expected to develop arthritis, which contributes to spinal stenosis. "Researchers performed MRIs on the spines of 100 healthy 30-year-olds. They indicated arthritic changes in the spine had already taken place in one third. For people over 65, there's almost a 100 percent chance their MRIs will show some abnormality. Just because spinal stenosis is diagnosed doesn't mean you have to have surgery, but it allows you and your doctor to monitor the changes and choose treatment," says Dr. Bergeson.

Common Treatment for Spinal Stenosis

Recommended treatments for spinal stenosis generally progress as the condition worsens over time. They may include:

  • Physical therapy. Improved muscle tone may help provide support for your spine, improve balance, improve over all conditioning and keep you more flexible.
  • Medications. Over-the-counter and prescription anti-inflammatory drugs may be helpful in reducing symptoms.
  • Back brace. This corset-like device may provide temporary support and relief for people.
  • Steroid injections. Anti-inflammatory medications injected into the space near the nerve roots.
  • Surgery. To relieve pressure on the nerves.

Symptoms of Spinal Stenosis

Dr. Bergeson describes common symptoms sufferers may notice:

  • Pain and difficulty walking.
  • Weakness or a heavy, tired feeling in the legs with standing or walking.
  • Sensory changes in the legs such as tingling, numbness, hot or cold feelings.
  • Frequent falls.
  • Changes in gait.

Common Treatment for Spinal Stenosis

Recommended treatments for spinal stenosis generally progress as the condition worsens over time. They may include:

  • Physical therapy. Improved muscle tone may help provide support for your spine, improve balance, improve over-all conditioning and keep you more flexible.
  • Medications. Over-the-counter and prescription anti-inflammatory drugs may be helpful in reducing symptoms.
  • Back brace. This corset-like device may provide support and relief for people.
  • Steroid injections. Anti-inflammatory medications injected into the space near the nerve roots.
  • Surgery. Relieves pressure on the nerves.

For More Information

GoodHealth.com's online health encyclopedia provides more information about back pain, spinal stenosis and decision support for determining whether to have an MRI and whether to have surgery.

Ryan K. Bergeson, MD
Orthopaedic Spine Surgeon

301 Seton Parkway, Suite 305
Round Rock, TX 78665
(512) 388-2663

1904 Railroad Street
Georgetown, TX 78626
(512) 863-4563

Dr. Bergeson specializes in all aspects of spine surgery, including treatment of fractures, herniated discs, spinal stenosis, idiopathic scoliosis and degenerative arthritis of the spine. A native Texan, he attended Texas A&M University and completed his medical degree at the University of Texas Medical School at Houston. He participated in several extern studies that allowed him to travel abroad to Hungary and New Zealand. He completed his orthopaedic residency at the University of New Mexico, followed by a fellowship in spine surgery with the Leatherman Spine Institute in Louisville, KY.

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