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Old 01-22-2011, 08:58 AM   #1
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Lumbar spinal stenosis + osteoporosis (80 year old mom)

My mom (age 80) spent 3 weeks in the hospital (including 2 weeks in a rehab facility) from late Dec. to early January recovering from a severe acute flare-up of pain in her right hip and upper leg due to lumbar Spinal Stenosis. Her first flare-up was 1-1/2 years ago (that time, she went home from the hospital the next day). Her MRI also shows a bulging L3, measuring 5mm. Last year's lumbar MRI showed a 2mm bulge and severe osteoporosis.

She is very active and independent and has exercised almost daily for years. Her legs and arms are strong, which is helping her regain her strength very quickly after 3 weeks in the hospital. She looks and seems younger than her age and can rise from a chair as quickly as any 20-year-old.

She's now doing small chores around the house including laundry, heating up food, and all of her self-care needs. She's able to walk short distances and climb stairs (she lives in a 2-story home) before the pain kicks in. When it does, she sits down 10-15 minutes, waits for it to pass, and gets up again. Standing is most painful and can do that for only very brief periods. She was provided a walker, but doesn't need it. She can drive completely pain-free.

She's had 2 epidural injections and believes they are helping (that could be anecdotal as she recovered without them after her previous flare-up). She started PT on Thursday and was very impressed with her therapist and the center, and believes they can help her.

She is not opposed to surgery as a last resort. Her only other health issue is high BP.

Wondering if anyone can share treatment alternatives for an active older person like her, with her combination of back problems.

 
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Old 01-22-2011, 01:12 PM   #2
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Re: Lumbar spinal stenosis + osteoporosis (80 year old mom)

Has any surgeon suggested a fusion to her? I'm not sure with osteoporosis, if it can be done successfully. But if it could, it would probably help with the pain in her hip and leg. My MIL underwent a fusion at L4-5 when she was 87 and is going very well at age almost 91.

But as you already said, it would be a last resort. Hopefully with continued PT and an occasional ESI, she will be able to tolerate whatever pain she has. Stenosis is one of those things that does not improve with age, but sometimes it can be dealt with through the appropriate exercises, anti-inflammatory medications, etc.

It's great your mom is so active. That should help her condition.

 
Old 01-23-2011, 09:41 AM   #3
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Re: Lumbar spinal stenosis + osteoporosis (80 year old mom)

Thank you very much for your reply.

She has not seen a surgeon yet; she's been home only a week, and started PT last Thursday. She'll continue PT 3x/week and return to the epidural doc next Monday for further evaluation.

At her first PT appointment, the therapist explained that her symptoms are due to the spinal stenosis, not the bulging disk. So, I'm wondering how exercises can improve that, except to strengthen the muscles to help support the structures and keep them aligned.

I am so glad that she is active and regularly exercises on her own. She was widowed 3 years ago, but continued to exercise and take care of herself. She's been going to Curves almost daily for 8 years, and the ladies there call her "the human pretzel" because she is very flexible. She's also a hospital volunteer and prefers a role in which she can walk around instead of sit at a desk.

Let me tell you ---- exercise makes all the difference! After 3 weeks in the hospital, most 80-year-olds would be so weak after returning home that they'd want to just sit in a chair. No, not her --- yesterday she did a little dusting of the furniture, and has been sorting through her Christmas items before putting them away for another year. She does what she can until pain flares up, then sits until it subsides, and gets up and walks around again.

I believe the true cause of her flare-ups is STRESS and DOING TOO MUCH. I don't understand exactly how stress sets things in motion to act as a catalyst of a spinal stenosis flare-up, but that is the common denominator both times. By her own admission, she tends to be compulsive about "getting things done". I try to encourage her to set aside one or two days a week for those things.

 
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