What it is
Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back that can compress the nerves travelling to the legs. It typically develops gradually as a result of age-related degenerative changes.
Symptoms
- Leg pain, heaviness or cramping that worsens with walking or standing
- Relief of symptoms on sitting or bending forward
- Reduced walking distance over time
- Numbness or weakness in the legs
- Balance difficulty in more advanced cases
Causes
- Degenerative disc bulging
- Thickening of spinal ligaments
- Facet joint enlargement
- Degenerative spondylolisthesis
Diagnosis
Diagnosis is based on the characteristic pattern of walking-related leg symptoms, combined with MRI confirmation of canal narrowing at one or more levels.
MRI findings
MRI demonstrates narrowing of the central spinal canal, lateral recesses or neural foramina, often at multiple lumbar levels, with corresponding compression of the traversing nerve roots.
Non-surgical treatment
- Physiotherapy focused on flexion-based exercises and conditioning
- Activity pacing
- Anti-inflammatory medication
- Epidural steroid injections
Considering this for your case?
Send your MRI or CT for a specialist opinion before deciding on treatment.
When surgery may be considered
Surgery is generally discussed when walking distance is significantly and progressively limited despite conservative care, or when there is progressive neurological involvement.
Surgical options
- Laminectomy
- Minimally invasive decompression
- Decompression combined with fusion in cases with instability
Recovery
Walking distance typically improves within weeks of decompression surgery, with continued gains over 2–3 months as conditioning improves.
Risks
- Dural tear
- Recurrent stenosis at an adjacent level over time
- Infection
- Incomplete relief in long-standing severe cases
Questions to ask your surgeon
- Is surgery necessary now, or can it reasonably wait?
- What non-surgical options are appropriate for my case?
- What are the realistic risks and recovery timeline for me specifically?
Indicative treatment cost
Costs vary by procedure and case complexity. See the spine surgery cost page for indicative planning ranges.
Frequently asked questions
No. Most cases are managed with non-surgical treatment first. Surgery is discussed only when appropriate criteria are met, as outlined above.
Diagnosis is based on the characteristic pattern of walking-related leg symptoms, combined with MRI confirmation of canal narrowing at one or more levels.
Recent MRI or CT images and reports, a summary of symptoms and duration, and details of any treatment already tried.