Lumbar spinal stenosis

What it is

With age, the discs settle, the facet joints enlarge, and the ligament at the back of the canal thickens. Together these gradually reduce the space available to the nerves. Standing and walking narrow the canal further; bending forward opens it.

That mechanical relationship explains the hallmark of stenosis: symptoms that appear after a predictable walking distance and disappear within minutes of sitting or leaning on a shopping trolley.

What it feels like

• Heaviness, cramping, or burning in both legs after walking a certain distance.
• Relief on sitting, leaning forward, or going uphill; worse going downhill or standing still.
• Back pain, though the leg symptoms are usually what limits you.
• Gradually shrinking walking distance over months or years.

How it is assessed

The walking pattern is highly characteristic and is often enough to make the diagnosis clinically. An MRI confirms the levels involved and how tight they are.

Because leg symptoms on walking can also come from circulation, the assessment includes checking the pulses in the legs. Vascular and spinal causes can coexist.

Treatment

Treatment depends on your symptoms, nerve function, and daily activities. Physiotherapy, activity adjustments, and medication can help some people. An injection may provide temporary relief in selected cases.

When symptoms remain limiting, decompression can create more space for the nerves. Fusion is considered separately, based on factors such as instability, alignment, and the planned decompression. New weakness or bladder or bowel changes need urgent assessment.