Lumbar spinal stenosis occurs when the spinal canal in the lower back narrows, putting pressure on the spinal cord and nerve roots. This narrowing typically develops gradually over time as part of the aging process.
The condition is one of the most common causes of back and leg pain in adults over 50. Many patients notice that symptoms improve when sitting or leaning forward and worsen when standing or walking. This pattern is characteristic of spinal stenosis.
Symptoms of Lumbar Spinal Stenosis
The most common symptom is leg pain or cramping that develops when standing or walking and improves with rest or sitting. This is often described as neurogenic claudication. Patients frequently report that leaning on a shopping cart provides relief.
Other symptoms include numbness, tingling, or weakness in the legs and feet. Lower back pain may or may not be present. As the condition progresses, the distance you can walk comfortably may gradually decrease.
What Causes Lumbar Spinal Stenosis?
The most common cause is age related changes in the spine. Arthritis leads to thickening of the ligaments and enlargement of the facet joints, both of which reduce space in the spinal canal. Disc bulging and bone spur formation contribute to the narrowing.
Some people are born with a naturally narrow spinal canal, which makes them more susceptible to developing symptoms. Previous spine injuries, tumors, and certain bone diseases can also cause or contribute to stenosis.
Our Diagnosis Approach to Lumbar Spinal Stenosis
Diagnosis begins with a detailed discussion of your symptoms and a physical examination. The pattern of pain with walking that improves with rest or bending forward is an important diagnostic clue. Dr. Sperzel will assess your gait, strength, and reflexes.
MRI provides detailed images of the spinal canal and surrounding structures, showing where narrowing is occurring. Standing X rays may reveal instability or alignment issues. In some cases, diagnostic injections help identify which levels are contributing to your symptoms.
Evidence-Based Treatments
Initial treatment often includes physical therapy focused on core strengthening and flexibility, along with activity modifications. Many patients benefit from exercises that promote a slightly flexed spine position.
Epidural steroid injections can reduce inflammation and provide relief for patients with moderate to severe symptoms. For select patients, minimally invasive procedures such as the MILD procedure may create more space in the spinal canal. Dr. Sperzel will recommend the approach best suited to your condition.
When to Seek Care
Seek evaluation if leg pain or cramping limits your ability to walk, stand, or perform daily activities. If you notice that your walking tolerance is gradually decreasing, early intervention may help preserve your mobility.
Seek immediate care if you experience sudden severe weakness in the legs, loss of bowel or bladder control, or numbness in the groin area. These symptoms are rare but require urgent evaluation.
