Ten informants, five women and five men expressed how they experienced Lumbar Spinal Stenosis symptoms before surgery, and their situation after treatment. They were aged 61 to 79 years. Three themes express their experiences: (1) Rapid recovery from pain (2) Significant improvement in functional level (3) Remarkable improvement in quality of life after surgery.
Rapid recovery from pain
The patients spoke of having experienced pain for many years. They described the pain as long lasting, strong and constant. Mostly they had experienced pain during activity. The pain was located in the lower back and in one or both of the lower extremities. The pain was described as «a glowing iron stitch toward the hip» (N1), and «it felt as though it was squeezing my thighs and sometimes the pain went down to the ankles» (N3). Those who had pain in the backbone experienced a soothing effect when they sat down or whilst they bent forward. Several of the informants reported that they had experienced palsy in one or both of the lower limbs. They described it with words like «tingling, pricking and numbness». Most experienced palsy in the bottom and thighs, some completely down to the toes.
After surgery, the patients spoke of rapid recovery from pain. They had experienced immediate change and referred to being without pain even before leaving hospital. «As soon as I woke up, and was able stand on my feet, I realized I couldn`t feel any pain. I cried, it felt fantastic, it was like giving birth» (N4). The patients’ narratives about surgical treatment were communicated in an emotional and grateful manner. Some of the patients said that the recovery was gradual. One of them declared that after two months he felt «free of pain» (N1). However, another said that he still experienced pain. Most patients who had experienced paralysis and weakness of the lower extremities before the operation had noted a feeling of improvement immediately after the surgical treatment. This was always the first real experience of improvement mentioned after treatment. A short time after the operation, a few of the informants could still feel a slight numbness in the toes, but to a far lower degree.
Significant improvement in functional level
The patients communicated that the pain due to Lumbar Spinal Stenosis had led to reduced functional capacity and put limitations on their daily activity and social participation. One of the symptoms that was communicated was that the foot began to shake. A sense of stiffness and pain when starting any activity was described. This led to walking with small steps in fear of the foot giving way. Several had experienced an occasional failure of one of the lower limbs. The patients described the functional limitations they had to face in everyday life and that it was crucial for when one would try to embark on any daily activity. One of the patients described his experience of limitations with »at all times it was not easy, I asked my wife about things I usually could do by myself» (N5).
The patients said that they used crutches and were even supported by available fixtures in the house during relocation. The patients described an isolated existence. It was described for example as »for almost a year I couldn`t manage to do anything» (N4). They spoke of how difficult it was to participate in recreational activities. One of the patients said that he had to reduce using his car and also described his limitations by «I walked only short distances before the pain started» (N1). Most described a walking distance of 200-300 meters, while for some it was even more limited.
After surgery most patients described the situation as «much better», however some patients reported experiences with less positive outcomes. Among the patients who had experienced significant improvement in function, most could perform daily tasks and gradually resume leisure activities. One of the patients said that walking steps was still a challenge, because muscles were still weakened due to prolonged immobility. Another said that after a year of isolation he could go fishing daily; he shone during the conversation and showed great pleasure in his new life situation. A patient spoke about improvement of function and described it as «being able to walk all the way through the corridor, and that she even was able to walk up the steps». After returning home, she could report «I`m doing exactly what I want, I`m doing my housework and cooking, I walk longer distances, up to five kilometers» (N2). There were reports of cases of complications with outcomes such as reduced activity levels and increased fallout. One of the patients could announce immediate improvement of paresis but that the pain gradually had returned.
Remarkable improvement in quality of life after surgery
Quality of life before the operation was described as bad. Life was mostly about short evenings and poor sleep quality. Some of the patients felt depressed because of this overall poor quality of life. The patients spoke of how crucial their own motivation and will power had been to overcome the challenges of everyday life. They felt loss of freedom and «useless and helpless» (N3). Patients described that they «mostly stayed inside their home» (N4). The patients explained that the poor quality of life was the reason for choosing the operation. The stories conveyed the feeling that several had been waiting too long before receiving treatment.
After treatment, the quality of life was described as good by most of the patients. One of the patients told us how good the quality of life had become compared to what it had been the past few years. «I can now go further distances without doing any exercise» (N1). Another reported that although he had high expectations of the outcome of surgery, he had none the less not realized the outcome would be so successful, «I felt like a new person» (N2), another described it as «the feeling of a completely new life» (N8). The patients spoke of the remarkable and strong contrast as they described their quality of life before and after the surgical treatment. One of the patients spoke of the possibility to participate more in social life by «now I work 100%, there’s nothing to stop me» (N3). It was not everyone who experienced improvement in quality of life as a result of treatment. It was also described as a small improvement (N7). Another reported that she was unsure about the final result of treatment (N6).