Spinal Stenosis: Causes, Symptoms, Relief, and Specialist Care

What Is Spinal Stenosis?

Spinal stenosis is a condition where the open spaces within your spine become narrowed, placing pressure on the spinal cord and nerves that travel through the back and neck. Most commonly, this narrowing develops in the lower back (lumbar spine) or the neck (cervical spine), although it can occur anywhere along the spine. Spinal stenosis is often described as “nerve compression,” “pinched nerve,” or “degenerative spinal narrowing.” Over time, this pressure can interfere with the communication between the brain and the rest of the body, causing pain and changes in sensation or strength. Some people experience symptoms only when standing or walking, while others notice ongoing discomfort, weakness, or numbness.

Why It Happens

Spinal stenosis is most often the result of natural changes that come with aging, but several specific factors can play a role:

• Age-Related Changes: As we age, the tissues in the spine—including discs, ligaments, and joints—begin to degenerate. Thickening of ligaments, bone spur formation (osteophytes), and the shrinking or drying out of spinal discs can all contribute to narrowing of the spinal canal.
• Arthritis: Osteoarthritis, the most common form of arthritis, can lead to excess bone growth and inflammation around the joints of the spine. Rheumatoid arthritis can also play a role, though less frequently.
• Herniated or Bulging Discs: When spinal discs become weakened or damaged, the soft inner material may bulge or rupture, putting extra pressure on nearby nerves.
• Spinal Injuries: Trauma from accidents, falls, or prior back surgery can cause swelling, dislocation, or post-surgical scar tissue, narrowing the spinal canal.
• Congenital Conditions: Some individuals are born with a spinal canal that is naturally narrower than average, which increases their risk of developing symptoms earlier in life.
• Occupation and Sports: Repetitive heavy lifting, prolonged sitting or standing, or activities that put frequent stress on the spine can accelerate degenerative changes and increase risk, especially for those in construction, warehouse work, or high-impact athletics.

Understanding the specific cause of spinal stenosis in your situation allows us to personalize your care and improve your comfort.

Signs & Symptoms

Symptoms of spinal stenosis can develop gradually and may be overlooked at first. Paying close attention to the type, location, and timing of pain is important for early diagnosis and treatment.

Common signs and symptoms include:

• Pain: Aching, burning, or “electric” pain in the lower back, buttocks, or legs (lumbar stenosis); neck, shoulders, arms, or hands (cervical stenosis).
• Numbness or Tingling: Loss of sensation or a “pins-and-needles” feeling in the legs, feet, arms, or hands.
• Weakness: Legs or arms may feel heavy, weak, or less coordinated—making walking or using the hands more difficult.
• Balance Problems: Trouble walking straight or frequent stumbling.
• Symptoms Worsen With Activity: Pain or numbness often increases when standing, walking, or leaning backward, and improves when sitting or bending forward.
  Relief With Rest: Sitting, lying down, or bending forward (such as over a shopping cart) can temporarily relieve symptoms.

Red-Flag Warnings:

Seek immediate medical care if you experience sudden loss of bladder or bowel control, rapidly worsening weakness, or severe numbness. These could indicate serious nerve involvement and require urgent attention.

Diagnosing Spinal Stenosis

• At Precision Pain and Spine Institute, we believe a thorough, patient-focused diagnosis is key to effective treatment. Here’s what you can expect at your first visit:
• Clinical Interview: We start with a discussion about your symptoms—when they started, what makes them better or worse, and how they affect your daily life.
  Physical Exam: Your doctor will check your posture, reflexes, muscle strength, sensation, and walking pattern to pinpoint nerve involvement.
• Imaging Studies:
  • X-rays show changes in bone structure, arthritis, or alignment problems.
  • MRI provides a detailed view of spinal nerves, discs, and soft tissues, helping identify areas of nerve compression or herniation.
  • CT Scan may be used if MRI is not possible, or for more detail on bone changes.
• Electrodiagnostic Testing (EMG/NCS): If symptoms are severe, confusing, or not explained by imaging, an EMG (electromyography) or nerve conduction study can help determine exactly which nerves are affected and rule out other causes. Learn more about EMG testing and diagnosis .

We walk you through each test and answer every question so you feel informed and confident about your care.

Treatment Options

We offer a full spectrum of care for spinal stenosis, with a strong emphasis on conservative, non-surgical management first:

Conservative Care

• Physical Therapy:
  • Customized exercise programs focus on stretching, strengthening the back and abdominal muscles, and improving balance and flexibility.
  • Therapy helps restore mobility, relieve nerve pressure, and promote long-term spinal health.
• Medications:
  • Anti-inflammatory medications (NSAIDs), acetaminophen, or medications for nerve pain (such as gabapentin) can reduce discomfort and improve daily function.
• Epidural Steroid Injections:
  • For moderate to severe symptoms, targeted injections reduce inflammation around pinched nerves and can provide weeks to months of relief.
• Chiropractic Care:
  • Gentle spinal adjustments may help select patients with mild to moderate stenosis. Our chiropractors coordinate care with our medical team to ensure safety. Explore chiropractic care.

Regenerative or Minimally Invasive Procedures

If standard treatments are not enough, advanced options—such as image-guided injections or nerve ablation—may provide additional relief and avoid or delay surgery.

Surgical Treatment

Surgery is considered only when symptoms are severe, progressive, or disabling, or when non-surgical options have failed.

• Laminectomy (Decompression Surgery): Removal of the bone or ligament causing nerve compression to create more space for spinal nerves.
• Minimally Invasive Spine Surgery: Smaller incisions, less disruption to muscles, and quicker recovery compared to traditional open surgery.
• Fusion Procedures: Rarely, if instability or deformity is present, spinal fusion may be recommended to stabilize the area.

Living With Spinal Stenosis

Many people can manage spinal stenosis and stay active with the right habits and care. Our team provides ongoing education and support for every patient:

• Stay Active: Regular movement - like short walks or gentle pool exercises - can prevent stiffness and keep your muscles strong.
• Stretch and Strengthen: Daily stretches for the back, hips, and legs help relieve tension and maintain mobility. Your physical therapist can provide a safe, tailored program.
• Workplace Modifications: Use ergonomic chairs, adjust desk height, and take frequent breaks if you sit or stand for long periods.
• Footwear: Wear cushioned, supportive shoes to reduce impact on your spine.
• Sleep: Find a comfortable position; often on your side with a pillow between your knees, or on your back with support under your legs.
• Mental Health: Chronic pain can impact your mood. Staying connected with friends, joining a support group, and practicing relaxation techniques can help.
• Pace Yourself: Plan activities in short bursts with rest in between, rather than pushing through pain.

Our rehabilitation specialists can provide more daily-life tips to fit your needs and routines.

Prevention Tips

While not all cases of spinal stenosis can be prevented, there are ways to protect your spine and delay progression:

• Maintain a Healthy Weight: Extra weight increases pressure on spinal joints and nerves.
• Use Proper Lifting Technique: Bend at the knees, keep objects close to your body, and avoid twisting while lifting.
• Posture Awareness: Stand tall, avoid slouching, and use lumbar support when sitting.
• Conditioning Drills: Regular strength and flexibility exercises—especially for the core and hips—help support your spine.
• Quit Smoking: Smoking can accelerate spinal degeneration and slow healing.
• Stay Active: Even low-impact exercise like walking or swimming benefits your spinal health.

Ask your provider for more personalized prevention strategies based on your lifestyle and risk factors.

How We Can Help

At Precision Pain and Spine Institute, our board-certified orthopedic spine surgeons, pain management physicians, chiropractors, and physical therapists collaborate to provide comprehensive care. We use advanced imaging, precision diagnostics, and the latest non-surgical and minimally invasive treatments—all under one roof. Same-week appointments and a patient-first approach mean you get answers and relief quickly.

Frequently Asked Questions (FAQs)

1. How long does spinal stenosis pain usually last?

It varies: some people have occasional flares, while others experience ongoing symptoms. Many find improvement with conservative care within weeks to months.

2. Is spinal stenosis always progressive?

Not always. With the right treatment and lifestyle changes, many patients stabilize or improve, though some may see symptoms progress over time.

3. Do I need surgery if I have spinal stenosis? 

Surgery is only considered if non-surgical treatments fail, or if you develop severe or worsening weakness, numbness, or loss of function.

4. What are the risks of waiting to treat spinal stenosis?

Delaying care can lead to worsening pain, mobility problems, or permanent nerve damage in rare cases. Early evaluation helps protect your health.

5. Can physical therapy help?

Yes, it’s a mainstay of treatment for mild to moderate cases and helps many patients avoid surgery.

6. What should I avoid if I have spinal stenosis?

Avoid prolonged standing, heavy lifting, and activities that worsen symptoms. Your provider can give you safe activity guidelines.

7. How do I know if I need an EMG test?

EMG is helpful if symptoms don’t match imaging results, are severe, or to rule out other nerve problems.

Related Internal Links:

• Spine Surgery Services
• Orthopedic Pain Treatment
• Pain Management
• Physical Therapy
• EMG Testing