About lumbar spinal stenosis
The spinal canal is the tunnel that carries the nerves through the low back. With age, thickened ligaments, bone spurs, and bulging discs can narrow it. When the nerves are crowded, standing upright and walking can trigger leg pain, tingling, or heaviness, a pattern called neurogenic claudication.
Leaning forward opens the canal slightly, which is why many people feel better pushing a shopping cart or sitting down. Seek urgent care for loss of bladder or bowel control, numbness in the groin, or rapidly worsening leg weakness.
Common symptoms
- Pain, heaviness, or cramping in the buttocks or legs with standing or walking
- Relief with sitting or bending forward
- Numbness or tingling in the legs or feet
- Low back pain or stiffness
- Needing to stop and rest after walking shorter distances than before
Common causes and risk factors
- Thickening of the ligament at the back of the spinal canal
- Bone spurs and enlarged facet joints from spine arthritis
- Disc bulges and disc height loss
- A vertebra that has slipped slightly forward, called spondylolisthesis
How we diagnose it
Dr. Chen asks how far you can walk, what makes the legs better, and checks strength, reflexes, sensation, and circulation, since poor blood flow in the legs can cause similar symptoms. MRI shows the location and degree of narrowing and whether thickened ligament is a major contributor. EMG and nerve conduction testing may help when neuropathy or another nerve problem could also be playing a role.
How Propel treats lumbar spinal stenosis
Care starts with a progressive program that builds leg and trunk strength and walking tolerance, often using flexed-position exercises such as cycling. Staying active matters, and we help you find ways to keep exercising while the plan takes hold.
When symptoms continue to limit walking, Dr. Chen may recommend an epidural steroid injection to calm the irritated nerves. For stenosis driven largely by a thickened ligament, MILD is a minimally invasive outpatient procedure that removes excess tissue through a small opening, typically performed in a procedure facility. If stenosis is severe or causing progressive weakness, we help coordinate a surgical referral.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about lumbar spinal stenosis
- What is the MILD procedure?
- MILD stands for minimally invasive lumbar decompression. Through a small opening in the back and with image guidance, small tools remove part of the thickened ligament that is crowding the nerves. It is an outpatient procedure, and most people go home the same day.
- Is walking good for spinal stenosis?
- Yes, staying active is important, even if you need to take breaks. Walking in short intervals, using a cart or trekking poles, and adding cycling can help you build endurance without flaring symptoms.
- When is surgery needed for spinal stenosis?
- Surgery is considered when there is progressive weakness, problems with bladder or bowel control, or disabling symptoms that have not improved with other care. We help coordinate referral to a spine surgeon when that is the right step.