Lumbar Spinal Stenosis
Narrowing of the spinal canal that compresses nerves in the lower back
Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back that puts pressure on the spinal cord and nerve roots. It most commonly affects adults over 50 as a result of normal age-related changes. The hallmark symptom is neurogenic claudication — leg pain, cramping, or weakness that worsens with walking or standing and improves with sitting or bending forward.
Symptoms
- Leg pain, cramping, or heaviness with walking or standing (neurogenic claudication)
- Symptoms that improve when sitting, leaning forward, or bending (e.g., using a shopping cart)
- Numbness or tingling in one or both legs
- Weakness in the legs, especially after prolonged activity
- Lower back pain (though leg symptoms often predominate)
- Bladder or bowel dysfunction in severe cases
Causes & Risk Factors
- Osteoarthritis and bone spur (osteophyte) formation narrowing the canal
- Thickening of the ligamentum flavum ligament
- Bulging or herniated discs encroaching on the canal
- Spondylolisthesis (vertebral slippage) reducing canal space
- Prior spinal surgery or trauma
- Congenital narrowing of the spinal canal (less common)
Treatment Options
Conservative (Non-Surgical)
- Physical therapy focusing on flexion-based exercises and core strengthening
- Anti-inflammatory medications (NSAIDs) for pain management
- Epidural steroid injections to reduce nerve inflammation
- Activity modification (walking aids, pacing strategies)
- Weight management to reduce spinal loading
Surgical Options
- Laminectomy — removal of the lamina to decompress the spinal canal
- Laminotomy — less invasive partial removal of the lamina
- Minimally invasive decompression (MILD procedure)
- Spinal fusion combined with decompression for cases with instability
- Interspinous spacer devices (X-STOP) for selected patients
When to see a spine specialist
Consult a spine specialist if leg pain, weakness, or numbness is limiting your daily activities, or if conservative treatments have not provided adequate relief after 3–6 months.
Frequently Asked Questions
What is the difference between lumbar stenosis and a herniated disc?
Both conditions can compress spinal nerves, but the mechanisms differ. A herniated disc involves disc material pushing against a nerve — often in a younger patient and usually at a single level. Lumbar stenosis is a broader narrowing of the spinal canal, typically from multiple age-related changes affecting a larger segment, and more commonly seen in patients over 50.
Can spinal stenosis get worse over time?
Stenosis often progresses slowly with age, but not everyone worsens significantly. Some people have stable symptoms for years. Rapid progression — especially with increasing leg weakness — warrants prompt evaluation by a spine specialist.
Is surgery effective for lumbar stenosis?
For appropriately selected patients, decompression surgery has a strong evidence base. Large clinical trials (including the SPORT trial) show that surgical treatment provides significantly more symptom relief than non-surgical care at 2–4 years, particularly for patients with severe neurogenic claudication.
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Medical disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider for diagnosis and treatment decisions. Last reviewed March 2026. ICD-10: M48.06.