Lumbar stenosis

This information may be useful for those who have been diagnosed with lumbar stenosis. People who are experiencing new or ongoing symptoms should visit their healthcare professional for assessment, diagnosis or treatment.

Read about managing a back problem

What is lumbar stenosis?

Lumbar stenosis refers to a back condition that mainly affects the legs. It occurs due to narrowing of the area of the spine that contains the nerves or spinal cord. This can lead to irritation or compression of the nerves which travel down the legs.  Narrowing is a normal part of the ageing process of the spine and may not always cause symptoms.

Although this condition can be painful, the nerves can learn to adapt to the change in space around the spine. The majority of people with this condition can manage their symptoms well with the right advice and information.

In some cases further help is necessary, particular if symptoms are impacting your walking distance or quality of life. This help can be provided by your healthcare professional.

Find out how to access MSK services

Symptoms of lumbar stenosis

 Symptoms like aching, cramping, tingling, heaviness and occasional weakness in the legs are usually brought on by walking or standing. They can be eased by sitting or leaning forward.

Patients with lumbar stenosis can also have back pain. However, low back pain with no leg symptoms is usually not thought to be caused by stenosis.  

Lumbar stenosis is a long term condition, and symptoms are often variable from day to day.  Many patients have found that managing their symptoms can help improve their quality of life. 

Diagnosing lumbar stenosis

In order for lumbar stenosis to be diagnosed you’ll need an assessment from a healthcare professional.

They’ll ask you questions about your back issue and then carry out a physical examination. This may include checking your range of movement and strength.

You may sometimes need to have a further examination to rule out other possible health conditions.

What causes lumbar stenosis ?  

As we get older, aging in the spine can cause narrowing and a reduction of space for the spinal nerves leading to irritation. Even then, nerves are resilient and can learn how to cope with this narrower tunnel.  

Clinicians may call the condition “central stenosis” or “foraminal stenosis”, depending on where the changes in your spine have happened.  

If your symptoms are getting worse or you can’t manage your pain, you should contact your healthcare provider.

When to get professional help

Rarely spinal stenosis can cause a condition called Cauda Equina Syndrome to develop. This is a rare but serious back condition which can lead to permanent damage or disability. If you develop this condition you’ll need to be seen by an emergency specialist spinal team.

Phone 111 if:

  • there has been a new, significant trauma within the last 7 days, for example a fall from height or direct blow to the back

Or you have experienced a new onset of the following symptoms:

  • loss of feeling/pins and needles between your inner thighs or genitals
  • numbness in or around your back passage or buttocks
  • altered feeling when using toilet paper to wipe yourself
  • increasing difficulty when you try to urinate
  • increasing difficulty when you try to stop or control your flow of urine
  • loss of sensation when you pass urine
  • leaking urine or recent need to use pads
  • not knowing when your bladder is either full or empty
  • inability to stop a bowel movement or leaking
  • loss of sensation when you pass a bowel motion
  • change in ability to achieve an erection or ejaculate
  • loss of sensation in genitals during sexual intercourse

Treatment for lumbar stenosis 

Many people can cope with their stenosis with a combination of time, modifying activity, and pacing themselves to allow the nerves to adapt.

If your symptoms are relieved by bending or leaning forward, many people find it helpful to have regular breaks when walking like taking a seat or leaning against a wall. If you’re struggling with your walking it may be helpful to talk to a healthcare professional about a walking aid or support.

Pain medication, staying active, and gentle exercise may also help.

Pain treatments

The following can help to reduce the pain:

  • pain medication – this can help you move more comfortably, which can help your recovery
  • heat or ice packs

More about taking painkillers.

Surgery

In some cases, surgery may be an option if symptoms are not improving and all other treatment options have been tried. The operation, called spinal decompression, involves reducing the pressure on the nerves affected by stenosis.

Work

A back problem can sometimes mean you need to take some time off work to help recovery. How long you’re off will depend on the nature of your condition and your role at work.

You do not need to be symptom free before you consider returning to work. Continuing to go to work, or returning to work as soon as is possible for you, will help your recovery. Gradually getting back to your normal daily activities can help to build up your strength and stamina levels.

Help and support

Following this advice, you should see gradual improvements over time.

You should see the biggest change in your symptoms within the first couple of weeks. Most problems should have improved within 6 weeks.

If your back problem hasn’t improved within 6 weeks of following this advice, or if your symptoms get worse at any time, talk to a healthcare professional about your symptoms.

How to access MSK services in your area

When dealing with any health condition it’s important to also look after your mental wellbeing as this can impact your recovery.


Last updated:
28 July 2023

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