Lumbar Spinal Stenosis

What is Lumbar Spinal Stenosis?

The spinal canal is the bony tunnel through which the spinal cord and nerve roots travel. In lumbar spinal stenosis, this canal narrows in the lower back, squeezing the nerves passing through it. The narrowing is usually gradual, driven by age-related changes: bone spurs form, discs bulge inward, and the ligaments thickening over decades take up space that once belonged to the nerves.

The most recognizable feature is neurogenic claudication: leg heaviness, cramping, or pain that builds during walking and is relieved by sitting down or bending forward. Leaning forward opens the canal slightly, which is why many patients instinctively walk with a trolley or find cycling easier than walking. Symptoms are typically in both legs, distinguishing stenosis from single-level disc herniation, which usually affects one side.

Stenosis is most common after the age of 50, though it can occur earlier in people with congenitally smaller canals or following spinal injury. It progresses slowly in most cases, and many people manage it well without surgery.

Symptoms

• Leg heaviness, cramping, or pain that builds during walking
• Symptoms relieved by sitting, bending forward, or leaning on a surface
• Numbness or tingling in both legs or feet
• Lower back ache, often dull rather than sharp
• Weakness in the legs with prolonged standing or activity
• Gradual reduction in the distance you can walk before needing to stop

How We Treat It

We treat lumbar spinal stenosis with a combination of nerve decompression and pain management strategies tailored to how much the condition is limiting daily life. Epidural steroid injections reduce inflammation around the compressed nerves and can meaningfully improve walking tolerance for months at a time. For patients with significant facet joint contribution to the narrowing, medial branch blocks followed by radiofrequency ablation provide relief that can last considerably longer.

Our approach is to establish which component of your stenosis is most responsible for your current symptoms, rather than treating the imaging finding alone. Many patients with severe-looking scans have manageable pain, and many with moderate scans are significantly limited: we treat what you’re experiencing, not just what we can measure. Surgery is occasionally the right answer, and when it is, we will tell you so clearly.