Spinal Stenosis Treatment

Medically reviewed by Joshua L. Hare, DO, Founder & Medical Director

What spinal stenosis is

Spinal stenosis is a narrowing of the spinal canal or the openings where nerves exit, most often from arthritis, thickened ligaments, or bulging discs as the spine ages. Lumbar stenosis is the most common form:[1] its hallmark is leg pain, heaviness, or weakness when standing or walking that eases when you sit down or lean forward. Cervical stenosis, in the neck, can affect the arms and hands. At IPC, evaluation matches your symptoms to the levels shown on imaging. Treatment options include epidural steroid injections at the affected level and, for appropriate candidates with neurogenic claudication, minimally invasive options such as the MILD procedure or an interspinous spacer.

Symptoms of spinal stenosis

Symptoms depend on where the narrowing is; the lumbar spine is the most common site.

• Leg pain, heaviness, cramping or weakness that comes on with standing or walking and eases within minutes of sitting down or leaning forward — leaning on a shopping cart is the classic relief position
• A walking distance that has gradually shrunk over months or years
• Low back pain, often milder than the leg symptoms
• Numbness or tingling in the legs or feet
• With narrowing in the neck: aching in the arms, clumsiness in the hands, or changes in balance

Many people over 60 have some narrowing on a scan without symptoms, so what matters — and what an evaluation works out — is whether the narrowing seen on imaging actually explains the symptoms you have.

When to see a pain specialist about spinal stenosis

Arrange an evaluation if leg symptoms are limiting how far you can walk or how long you can stand, or if back and leg pain has stopped responding to activity changes and over-the-counter medication. Epidural steroid injections can reduce inflammation around the compressed nerves, and because they are delivered to a specific level under X-ray guidance, they also help confirm which levels are responsible. For lumbar stenosis with claudication symptoms, minimally invasive options exist between injections and open surgery; whether you are a candidate depends on your anatomy, and that is exactly what the evaluation establishes.

Weakness in the legs that is getting worse, new trouble with balance, or repeated falls need prompt assessment. New loss of bladder or bowel control, or numbness in the saddle area, needs same-day emergency assessment.

Treatment options for spinal stenosis

Injections are usually the first interventional step. The two device options below are specifically for lumbar stenosis with neurogenic claudication; whether you are a candidate is something your physician will help you judge.

References

Clinical sources for this page.

1. Lumbar Spinal Stenosis. StatPearls [Internet], National Library of Medicine; updated January 30, 2024. Back to first citation ↑