Chapel Hill, NC

Spinal
Stenosis

Difficulty walking? Leg pain and numbness that improves when you sit or lean forward? Moderate spinal stenosis often responds well to conservative treatment and may not require surgery.

What is Spinal Stenosis?

Spinal stenosis is a narrowing of the spaces within your spine, which puts pressure on the nerves traveling through it. This narrowing can occur in the central canal (where the spinal cord runs) or in the side openings (foramina) where nerve roots exit.

Unlike a disc herniation, which produces rapid onset of symptoms, stenosis typically causes symptoms that progress slowly over time. The compression leads to inflammation of the spinal nerves, causing pain, weakness, and numbness that often worsens with walking or standing.

A hallmark symptom is "neurogenic claudication," where leg pain and weakness improve when you sit down or lean forward (like pushing a shopping cart), because these positions open up the spinal canal slightly.

Common Symptoms

  • Leg pain, cramping, or heaviness with walking
  • Numbness or tingling in legs or feet
  • Relief when sitting or bending forward
  • Weakness in legs or feet
  • Decreased walking distance over time
  • Low back pain (often less severe than leg symptoms)

Causes of Stenosis

  • Arthritis: Bone spurs and thickened ligaments
  • Disc degeneration: Bulging discs reduce space
  • Facet hypertrophy: Enlarged facet joints
  • Ligamentum flavum: Thickened spinal ligaments
  • Spondylolisthesis: Vertebra slipping forward

Treatment Options

Pain from mild to moderate stenosis often improves with physical therapy, core exercise, and regenerative treatments. Surgery is reserved for severe cases.

When Surgery May Be Needed

Severe compression with progressive numbness, weakness, or loss of bowel/bladder function may respond best to surgery to relieve pressure on the nerves. An MRI helps determine whether surgery or conservative treatment is the best option.

Frequently Asked Questions

Yes, many people with mild to moderate spinal stenosis improve significantly with conservative treatment. Physical therapy, core strengthening, and regenerative therapies can reduce symptoms and improve function. Research shows that about 70% of people with stenosis can be managed without surgery.

Stenosis compresses spinal nerves, leading to chronic inflammation and nerve pain. Regenerative therapies help restore the cytokine balance around the nerves and resolve this inflammation. While they cannot widen a narrowed canal, they can reduce the inflammatory component of symptoms.

Core strengthening is essential for spinal support. Cycling and swimming are often well-tolerated. We recommend working with a physical therapist to develop a safe, effective exercise program.

Keep Moving with Spinal Stenosis

You do not have to choose between pain and surgery. Schedule a consultation to learn how regenerative therapies can help your spinal stenosis.