What is lumbar spinal stenosis during pregnancy?
Lumbar spinal stenosis (LSS) is a narrowing of whats called the spinal canal (the tunnel surrounded by the bones of the spine, through which the spinal cord passes) in the lumbar spine, the spinal region that arches forward in the lower back. Stenosis can occur because of the growth of bone or other connective tissue within the canal. Because there is less space than normal, there is pressure on the spinal cord, but especially on the spinal nerves that branch off the spinal cord. Pregnancy can exacerbate this situation because the growth of the womb and stretching of the anterior abdominal muscles increase stress throughout the lumbar spine. As a result, you may experience weakness, anesthesia (numbness), paresthesia (tingling, pins and needles) or pain in certain areas supplied by lumbar spinal nerves, such as the buttocks, thighs, legs, and feet.
How common is lumbar spinal stenosis during pregnancy?
LSS strikes more than 200,000 people in the United States. Most affected people are above the age of 65, but its also possible for LSS to coincide with pregnancy. Various factors can increase your risk of developing LSS, including herniation of an intervertebral disc, which can happen due to a lower back injury or due to gradual strain.
How is LSS during pregnancy diagnosed?
If symptoms, such as weakness, numbness, tingling, and/or pain in the buttocks, thighs, legs, and feet hint at LSS as a condition that you may have, diagnosis can be made based on imaging that can include X-ray scanning of your lumbar spine showing bone spurs and narrowing of the spinal canal. During pregnancy, doctors typically avoid computerized tomography (CT) scanning, because it gives you a relatively high radiation dose compared with simple X-ray scans. However, magnetic resonance imaging (MRI) may be ordered to reveal detail of the spinal canal. Doctors also may order electromyography (EMG), which examines electrical activity and strength of muscles in affected regions.
Does LSS cause problems during pregnancy?
In addition to weakness, numbness, tingling, and/or pain in your lower extremities, LSS can cause incontinence, loss of control of the bladder or bowel.
Does LSS cause problems for the baby?
LSS does not have any direct consequences for the baby
What to consider about taking medications when you are pregnant or breastfeeding:
- The risks to yourself and your baby if you do not treat the LSS
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat lumbar spinal stenosis during pregnancy?
Outside of pregnancy, LSS is often treated with non-steroidal anti-inflammatory drugs (NSAIDs). These drugs pose risks to the baby when given both late pregnancy and early pregnancy. However, LSS also can be treated with corticosteroid medications injected around the affected nerves in whats called the epidural space (epidural steroid injection), which is relatively safe for the baby.
Who should NOT stop taking medication for LSS during pregnancy?
Stopping medication during pregnancy will not likely affect the long-term outcome of your condition, but there are medications that you can receive, such as injected corticosteroids, that will not pose a risk to the baby.
What should I know about choosing a medication for my LSS during pregnancy?
It is important to stay in communication with your health care provider as the release of new studies over time can change the outlook on the role of specific medications during pregnancy.
You may find Pregistrys expert reports about the medications to treat this condition here. Additional information can also be found in the sources listed below.
What should I know about taking a medication for my LSS when I am breastfeeding?
NSAIDs are considered to be fairly safe in mothers who are nursing. Corticosteroids can get into breastmilk from the mothers blood, but steroids given by epidural injection are concentrated around the site where they are needed, so very little spreads around the body and into the milk.
What alternative therapies besides medications can I use to treat my lumbar spinal stenosis during pregnancy?
LSS can be treated with physical therapy that can involve back braces for support, massage, stretching, and exercises designed to strengthen the back and leg muscles, and during early pregnancy and subsequent to giving birth to the abdominal muscles as well. Additionally, surgical procedures are available to widen the spinal canal and remove bone spurs, and also fuse two or more vertebrae (spinal bones) together to increase back stability.
What can I do for myself and my baby when I have LSS during pregnancy?
Follow the instructions of your physicians and physical therapists. Physical therapy can be very helpful, so take the exercises very seriously. Report any side effects of medications to your physicians. Additionally, it is helpful to maintain an appropriate weight for your stage of pregnancy and walk and stand with good posture.
Resources for LSS in pregnancy:
For more information about LSS during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446) or contact the following organizations: