"I'm Afraid I Won't Be Able to Walk Anymore" — You're Not Alone

An estimated 103 million people worldwide live with lumbar spinal stenosis. It is one of the most common spinal conditions, yet many people suffer in silence.

About This Column

Hello. My name is Dr. Hiroyuki Katoh, and I'm an orthopedic spine surgeon.

I treat patients with lower back and spine conditions. In my clinic, I hear the same words from many patients:

"When I'm walking, my legs start to hurt, and I have to stop."

"I'm fine when I'm pushing a shopping cart, but walking without one is miserable."

"My walks keep getting shorter and shorter..."

If any of this sounds familiar, it may be a sign of lumbar spinal stenosis (LSS), a condition where the spinal canal in your lower back narrows and presses on the nerves.

In this weekly column series, I'll explain this condition one step at a time, from how the disease works to treatment options and deciding whether surgery is right for you. I hope understanding it will make it less frightening.

A Condition Shared by Millions

Lumbar spinal stenosis affects roughly 1 in 10 people over the age of 50. In Japan alone, an estimated 5.8 million people have this condition. Studies suggest that up to 103 million people are affected worldwide, which makes it one of the leading causes of disability in older adults.

You almost certainly know someone, perhaps a neighbor, a friend, or a family member, who is dealing with the same thing.

This condition develops when the "tunnel" inside your spine (the spinal canal) gradually narrows with age, putting pressure on the nerves that run through it. Next week's column explains how this happens. For now, I want you to know one thing:

This is not your fault.

It is a natural change in a spine that has supported you for decades. You don't need to blame yourself for bad posture or not exercising enough.

Does This Sound Like You?

The most typical symptom of lumbar spinal stenosis is intermittent claudication. It goes like this:

• You're walking, and gradually your legs begin to ache, feel heavy, or go numb
• You stop and rest, sitting down or leaning forward, and the pain eases
• You start walking again, and after a while, the pain returns

Intermittent claudication: pain comes on with walking and eases with sitting or bending forward

"I used to walk for 30 minutes without stopping. Now I can barely manage 10." Does that sound like you?

Many people with this condition find that riding a bicycle feels perfectly fine, or that they can walk comfortably while pushing a shopping cart. Leaning forward slightly opens up the spinal canal and relieves the pressure on the nerves.

When you stand upright, the nerves are compressed, causing sciatica-like pain. When you lean forward, the pressure is relieved and the pain subsides.

"Toughing It Out" Is Not the Answer

In my clinic, many patients say things like:

"I can still walk, so I'm fine."

"It's just old age. Nothing can be done about it."

"I don't want to worry my family, so I keep it to myself."

I understand those feelings. But as a doctor, I have to be honest with you: enduring pain and numbness in silence is not always the right thing to do.

When nerves are compressed for a long time, they can become harder to heal.

Being able to tolerate the pain does not mean the condition isn't getting worse.

This does not mean you need surgery right away, or that something terrible is about to happen. But understanding your condition is the single best way to ease your anxiety.

Let's Learn Together Over the Coming Weeks

This column series runs for 24 weeks, in four stages that move from understanding to action:

Each week's column takes about 5 to 7 minutes to read.

You don't have to face this alone. Let's go through it together, one week at a time.