TAGMED Clinic Montreal / Mount Royal
Sténose lombaire, équilibre et chutes : quand la marche devient moins sécuritaire
Repères cliniques et fonctionnels dans un contexte de sténose lombaire avec douleur ou limitation dans les jambes.
Douleur, engourdissement ou faiblesse peuvent modifier la démarche, mais une perte d’équilibre ou des chutes ont souvent plusieurs causes possibles.
- Related page in this guide series Sciatica treatment in Montreal.
- La fonction, la marche et les signes neurologiques comptent autant que l’imagerie.
- Une faiblesse progressive ou des signes sévères modifient la priorité d’évaluation.
Understanding
Une sténose symptomatique se juge surtout par son impact réel
Douleur, engourdissement ou faiblesse peuvent modifier la démarche, mais une perte d’équilibre ou des chutes ont souvent plusieurs causes possibles.
Symptoms
Douleur, lourdeur, engourdissement ou faiblesse sont décrits selon leur trajet et leur déclenchement.
Function
La marche, la station debout et les activités quotidiennes mesurent le retentissement.
Concordance
L’examen et l’imagerie sont interprétés ensemble lorsqu’ils peuvent modifier les décisions.
Clinical interpretation
Pourquoi ce contexte mérite une analyse spécifique
La sécurité exige une analyse plus large que la colonne seule : vision, médicaments, condition physique et autres causes neurologiques ou vestibulaires peuvent aussi intervenir.
Key takeaways
La sévérité radiologique et la sévérité clinique ne sont pas nécessairement identiques. Les décisions restent individualisées.
Assessment
Relier les symptômes à la fonction
L’examen peut inclure la marche, les transferts, la force, la sensibilité, l’histoire des chutes et le contrôle postural.
1
Describe
Trajet, durée, déclenchement et récupération.
2
Mesurer
Marche, station debout, force et sensibilité.
3
Comparer
Relier les symptômes au contexte et à l’imagerie lorsqu’elle est disponible.
4
Decide
Choisir la prochaine étape selon la fonction, les déficits et les objectifs.
Support
Adapter les options au profil réel
Une aide à la marche, des adaptations de l’environnement et une orientation complémentaire peuvent être discutées lorsque cela améliore la sécurité.
Curator
Activité adaptée, exercice ou réadaptation et stratégies visant à préserver la capacité fonctionnelle.
Complementary modalities
Certaines options peuvent être discutées selon la cause probable, les objectifs et la réponse aux soins précédents.
Avis spécialisé
Peut devenir pertinent en cas de déficit progressif ou de limitation sévère persistante.
When should you seek prompt or emergency care?
- New, significant or rapidly progressive weakness.
- Recent foot drop or a leg that gives way increasingly often.
- New bladder or bowel problems.
- Numbness in the saddle area or perineum.
- Diminution rapide de la marche, symptômes bilatéraux importants, fièvre ou détérioration générale.
These signs should not wait for a routine appointment.
Follow-up
Mesurer l’évolution avec des objectifs fonctionnels
Le suivi tient compte des chutes, quasi-chutes, besoin d’appui et peur de marcher.
Walking:
Durée et distance avant l’apparition des symptômes.
Neurology
Évolution de la force, de la sensibilité et de la démarche.
Participation
Travail, loisirs et activités réellement retrouvés.
In the same guide series
Related guides
Vous souhaitez faire évaluer vos symptômes de sténose et de sciatique?
Une consultation peut aider à relier les symptômes, l’examen, la fonction et les examens déjà disponibles afin de déterminer les prochaines étapes appropriées.
Frequently Asked Questions
FAQ — Sténose lombaire, équilibre et chutes : quand la marche devient moins sécuritaire
La sténose peut-elle causer des chutes?
Elle peut contribuer par la douleur, l’engourdissement ou la faiblesse, mais d’autres causes doivent aussi être recherchées.
La marche doit-elle être arrêtée complètement?
Pas en principe. Une activité adaptée à la tolérance est généralement préférable à une inactivité prolongée, sauf consigne médicale spécifique.
Is an MRI always necessary?
Non. L’imagerie est surtout utile lorsqu’elle peut modifier la prise en charge ou lorsqu’un contexte particulier le justifie.
Une sténose visible à l’IRM explique-t-elle forcément les symptômes?
Non. Les images doivent être corrélées au côté, au trajet, à la fonction et à l’examen.
When should you seek medical help quickly?
En cas de faiblesse nouvelle, de diminution rapide de la marche ou d’aggravation neurologique.
Les symptômes peuvent-ils fluctuer?
Oui. La tolérance peut varier selon l’activité, la fatigue et d’autres facteurs.
Which signs require emergency care?
New bladder or bowel problems, saddle numbness or severe, rapidly progressive weakness.
Medical references
References and guidelines
Ces sources servent de repères généraux pour la sciatique, l’imagerie et la sténose lombaire. Elles ne remplacent pas une décision clinique individualisée.
- NICE NG59 — Low back pain and sciatica: assessment and management
- American College of Radiology — Appropriateness Criteria: Low Back Pain
- North American Spine Society — Diagnosis and Treatment of Degenerative Lumbar Spinal Stenosis
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Vanti, Carla, Luca Turone, Alice Panizzolo, Andrew A. Guccione, Lucia Bertozzi, and Paolo Pillastrini. 2021. “Vertical Traction for Lumbar Radiculopathy: A Systematic Review.” Archives of Physiotherapy 11(1): 7. http://doi.org/10.1186/s40945-021-00102-5.
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Upadhyay, S., S. Bhargava, and P. Porwal P. Porwal P. Porwal. “BACK PAIN: AN OVERVIEW BACK PAIN: AN OVERVIEW.” https://arastirmax.com/tr/system/files/dergiler/160852/makaleler/4/4/arastirmax-back-pain-overview.pdf (December 16, 2024).
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Pergolizzi Jr, Joseph V., and Darren FX Clair. 2008. “2 Prospective Evaluation of the Efficacy of Spinal Decompression via the DRX9000 for Chronic Low Back Pain.” Journal of Pain Practice: 2–8. https://www.discrepaircenter.com/Prospective%20Evaluation%20of%20the%20Efficacy%20of%20Spinal%20Decompression.pdf (December 16, 2024).
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Jimenez, Alex. “Healing Nutrients and Non-Surgical Decompression.” https://personalinjurydoctorgroup.com/2022/05/02/healing-nutrients-decompression/ (December 16, 2024).
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RELIEF, SIMPLE PELVIC TRACTION GIVES INCONSISTENT, TO HERNIATED LUMBAR, DISC SUFFERERS, and EDWARD L. EYERMAN. 1998. “Spinal Decompression Therapy Research.” Journal of Neuroimaging. https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=d20b26eb21c000ed3181c1beccc90689604aa5b3 (December 16, 2024).
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Pain, What Is Axial. “Conservative Treatment For Axial Spinal Decompression.” https://sciatica.clinic/conservative-treatment-axial-spinal-decompression/amp/ (December 16, 2024).
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Lo, Wai Leung Ambrose, Di Lei, Yan Leng, Huanjie Huang, Biru Wang, Qiuhua Yu, and Le Li. 2020. “Impact of Nonsurgical Spinal Decompression on Paraspinal Muscle Morphology and Mechanical Properties in Young Adults with Low Back Pain.” Journal of International Medical Research 48(7): 0300060520919232. http://doi.org/10.1177/0300060520919232.
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Jimenez, Alex. “Lumbar Traction Decompression Therapy For Low Back Pain.” https://personalinjurydoctorgroup.com/2022/04/22/lumbar-traction-decompression-therapy-low-back-pain/ (December 16, 2024).
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Martin, Craig W. 2012. “Vertebral Axial Decompression for Low Back Pain.” https://policycommons.net/artifacts/1199478/vertebral-axial-decompression-for-low-back-pain/1752602/ (December 16, 2024).
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Jimenez, Alex. “Your Weight Could Affect Your Back: Try Decompression.” https://personalinjurydoctorgroup.com/2022/05/12/weight-could-affect-back-decompression/ (December 16, 2024).
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Adar, Sevda, Onurhan Apaydın, Umit Dündar, Hasan Toktas, Hilal Yesil, Selma Eroglu, and Nuran Eyvaz. 2024. “Comparison of the Effectiveness of Traditional Motorized Traction and Non-Surgical Spinal Decompression Therapy Added to Conventional Physiotherapy for Treatment of Chronic Low Back Pain.” Cureus 16(9): e69610. https://pmc.ncbi.nlm.nih.gov/articles/PMC11420602/ (December 16, 2024).
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Naguib, Peter Ramzy, Mohsen Mohammed Elsayaad, Hassan Hussein Mohamed, and Yasser Ramzy Lasheen. “Efficacy of Side Lying Traction versus Supine Lying Traction in Treatment of Lumbar Disc Herniation: A Randomized Controlled Trial.” https://www.academia.edu/download/100590476/6639.pdf (December 16, 2024).
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Feng, Xian-xuan, Yi-ming Xu, Yun Cai, and Yue-hong Bai. 2018. “Non-Surgical Spinal Decompression System versus Conventional Traction Device for Treating Lumbar Disc Herniation through Surface Electromyography.” Chinese Journal of Tissue Engineering Research 22(7): 1032. https://www.cjter.com/EN/10.3969/j.issn.2095-4344.0113 (December 16, 2024).
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Important information
This page provides general information and does not establish a diagnosis. Results and recovery times vary according to the cause, duration, neurological signs, medical history and individual response to care.
Sylvain Desforges, docteur en ostéopathie
TAGMED Clinic — Spinal decompression, specific osteopathy and assessment of low back, disc-related and sciatic pain.
Professional profile · Contact · Main guide to sciatica in Montreal
