Spinal Stenosis

Spinal stenosis is the narrowing of the spinal canal or nerve passageways, often related to age-associated degenerative changes. It can cause back pain, leg pain, heaviness, numbness, or weakness, especially with walking or standing, and may improve when sitting or leaning forward.

At The Medical Group of New Jersey, we build a stepwise plan to improve walking tolerance and daily function.

Symptom Onset & Initial Evaluation

Common symptoms of spinal stenosis include:

• Leg pain, cramping, heaviness, or numbness with walking
• Symptoms that improve with sitting or bending forward
• Balance changes or leg weakness in more advanced cases
• Low back stiffness

Your provider will assess gait, strength, sensation, reflexes, and functional limitations (how far you can walk, how long you can stand).

Diagnosis

Spinal stenosis is diagnosed by combining clinical symptoms with imaging studies to confirm narrowing of the spinal canal and its impact on nearby nerves. Diagnostic evaluation may include:

• MRI: The primary imaging tool, used to confirm stenosis and assess the location and severity of nerve compression
• X-rays: To evaluate spinal alignment, degenerative arthritis, and signs of instability that may contribute to symptoms

Treatment

Treatment for spinal stenosis is tailored to symptom severity, functional limitations, and overall health, with a focus on improving mobility, reducing pain, and maintaining independence.

Rehabilitation & Function Restoration

Conservative treatment often begins with therapies designed to improve movement efficiency and reduce nerve compression during daily activities. This phase may include:

• Physical therapy focusing on posture correction, hip mobility, core strengthening, and walking strategies that reduce symptom provocation
• Activity pacing and conditioning plans to safely build endurance while minimizing symptom flare-ups

Medications & Interventions

When symptoms persist or limit quality of life, additional treatments may be introduced to improve comfort and function. These options can include:

• Anti-inflammatory medications, when appropriate to help manage pain and inflammation
• Targeted spinal injections for symptom relief in selected patients with persistent leg pain or functional limitation
• Surgical referral when symptoms are severe, progressive, or fail to improve with appropriate conservative care¹

1. Weinstein, James N., et al. “Surgical versus Nonsurgical Therapy for Lumbar Spinal Stenosis.” New England Journal of Medicine, vol. 358, no. 8, 21 Feb. 2008, pp. 794–810.

Ongoing Management & Long-Term Care

Long-term management of spinal stenosis focuses on maintaining mobility, reducing symptom progression, and supporting safety as activity levels change over time. Ongoing care may include:

• Progressive strengthening and conditioning to support spinal stability and functional endurance
• Fall-risk reduction strategies when balance, gait, or leg strength are affected
• Periodic reassessment if walking tolerance declines or symptoms change, allowing timely adjustment of the treatment plan