What it is
Lumbar stenosis is a narrowing of the space that carries the spinal nerves through the low back. Over time, disc bulges, ligament thickening, and arthritic changes in the joints can crowd that space and compress the nerves that run to the legs.
The hallmark symptom is neurogenic claudication — pain, heaviness, or cramping in the legs that starts or worsens with walking and gets better with sitting or leaning forward. Many people notice they can walk longer leaning on a shopping cart than walking upright.
How we approach it
Imaging (usually MRI) confirms where the narrowing is most severe, but the story and the physical exam drive the plan. Many patients with stenosis live well for years with a combination of activity modification, flexion-based physical therapy, targeted injections, and sometimes medications for nerve pain.
When surgery is considered
Surgery is considered when walking distance has become meaningfully limited, when symptoms are interfering with daily life, or when conservative options have stopped providing relief. For most patients with stenosis, the procedure is a laminectomy — a decompression that removes the bone and ligament crowding the nerves, without fusing the spine unless additional instability is present.
The goal is to restore your ability to move through your life — walk to the grocery store, hike, travel, keep up with family — not to chase an image on a scan.