Spinal stenosis — the narrowing of the spinal canal — is one of the most common spinal conditions in adults over 50. It develops gradually as arthritis, disc bulging, and ligament thickening reduce the space available for the spinal cord and nerve roots. When that space gets too tight, the nerves get compressed, and symptoms begin.
Symptoms to watch for
Lumbar stenosis (lower back) causes leg pain, heaviness, or cramping that worsens with walking or standing and improves when sitting or leaning forward. This pattern — called neurogenic claudication — is the hallmark symptom. Many patients notice they can walk further when leaning on a shopping cart because the forward lean opens the spinal canal.
Cervical stenosis (neck) can cause hand clumsiness, balance problems, and difficulty with fine motor tasks. These symptoms indicate spinal cord compression and require prompt evaluation.
Diagnosis
Spinal stenosis is diagnosed through a combination of physical examination, symptom history, and imaging. MRI is the gold standard for visualizing the degree of narrowing and nerve compression. At Restore Orthopedics, we have on-site MRI to diagnose and plan treatment in a single visit.
Treatment options
Conservative care: Physical therapy, anti-inflammatory medication, and epidural steroid injections can effectively manage mild to moderate stenosis. Dr. Eric Chang and Dr. Andrew Germanovich specialize in fluoroscopically-guided injections for precise relief.
Minimally invasive decompression: When symptoms persist despite conservative treatment — especially when walking distance is severely limited — surgery to decompress the nerve creates more space in the spinal canal. Dr. Gregory Carlson performs laminectomy and foraminotomy through small incisions using tubular retractors, minimizing tissue disruption and speeding recovery.
Spinal fusion: When stenosis is accompanied by instability or spondylolisthesis, fusion may be necessary to stabilize the spine after decompression. Modern techniques use smaller incisions and allow earlier mobilization than traditional open surgery.
The bottom line
Spinal stenosis rarely requires emergency treatment, but it tends to worsen over time. Early evaluation allows us to slow progression with conservative measures and plan intervention before the condition significantly limits your life.
Conservative treatment first
At Restore Orthopedics, we exhaust all conservative options before recommending surgery. Most stenosis patients see meaningful improvement with a combination of epidural steroid injections and targeted physical therapy. Surgery is reserved for those who have not responded after a thorough conservative trial.
Experiencing these symptoms? We can help.
Same-week appointments. Most insurances and Medicare accepted.
Call (714) 598-1745