Common Diagnosis
Lumbar Stenosis
Lumbar stenosis is a narrowing of the spinal canal that most often occurs at L4-5 or L3-4. It is a key cause of neurogenic claudication and typically worsens over time.
Overview
Neurogenic claudication is a symptom caused by central lumbar stenosis. Most of the time the stenosis is at L4-5, L3-4, or L2-3 with a combination of one or two continuous levels. Most patients present with stenosis at L4-5, or L3-4 and L4-5.
Symptoms usually start as generalized low back pain across the lower back, made worse with standing, walking, and extension. Over time, the patient or a family member may notice that the patient is frequently hunched or flexed forward a few minutes after standing from a seated position. As they begin walking, the pain worsens while flexion begins to relieve it.
Pain then travels down the legs bilaterally, sometimes affecting the anterior leg, posterior leg, or both. Once the patient sits down, symptoms begin to subside. Stenosis is a component of degenerative disc disease and can include a central disc herniation or facet hypertrophy.
Enlargement of the facet joint can be very painful, adding to the back pain. Compression of the nerves from lumbar stenosis causes leg pain or neurogenic claudication. Once symptoms start, they usually worsen over time.
Symptoms
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Causes
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When to see a specialist
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Non surgical treatment options
We offer comprehensive non surgical treatment plans tailored to each patient's condition, focused on pain relief, mobility improvement, and overall spinal health. While we do not perform these treatments in house, we collaborate with trusted local specialists to ensure you receive the highest level of care.
Physical therapy
We develop personalized physical therapy prescriptions based on your specific needs and refer you to experienced local providers. These programs are designed to improve strength, flexibility, and posture, helping to reduce pain and enhance mobility while promoting long term spinal health.
Epidural injections
For patients who may benefit from epidural steroid injections, we provide expert evaluations and referrals to trusted local physicians who specialize in pain management. These injections can reduce inflammation and nerve related pain caused by conditions such as herniated discs and spinal stenosis, offering significant relief with minimal downtime.
Chiropractic care and acupuncture
Chiropractic care can help patients with leg pain as a component of their condition. Acupuncture works best in the presence of severe muscle spasms. Both are considered alongside physical therapy and medication as part of a comprehensive conservative plan.
View all non surgical options →
Common treatments include non steroidal anti inflammatory agents, physical therapy, and epidural injections. Acupuncture and chiropractic care can help. Patients are also candidates for facet blocks to alleviate back pain. Patients also find relief from an epidural injection in the region of stenosis. If successful, physiatrists may inject up to three times in a twelve month period.
Surgical options
Patients are initially evaluated by a physiatrist to ensure all non surgical options, including physical therapy and non narcotic pain management, are exhausted before considering a surgical solution.
Lumbar laminectomy
This surgery is performed for patients who have lumbar stenosis presenting with neurogenic claudication. MRI shows compression of the nerve roots centrally at one or multiple levels. During surgery, the lamina are removed as well as a small part of the facet joint to decompress the nerves and thecal sac. The surgery takes approximately 45 minutes. Patients usually go home the same day.
Recovery
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Sources and further reading
Patient questions
Frequently asked questions
Our clinical team explains Lumbar Stenosis using your history, examination, and imaging. Symptoms vary by nerve or spinal cord involvement. An accurate diagnosis guides whether conservative care or surgery is the safest next step.
Symptoms may include neck or back pain, arm or leg pain, numbness, weakness, or balance changes when the spinal cord is involved. Severity and duration help determine urgency and treatment options.
Evaluation usually includes a neurological examination and MRI. X ray or CT may assess bone alignment. We correlate imaging with your symptoms before recommending injections, therapy, or surgery.
Physical therapy, medication, activity modification, and selective injections are common first steps. We monitor progress over four to eight weeks and escalate only when symptoms persist or neurologic deficits progress.
Seek urgent care for rapidly worsening weakness, loss of bowel or bladder control, saddle anesthesia, or severe pain after trauma. Call (914) 948 3008 for guidance if you are unsure how quickly to be seen.
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Office
Institute For Spine Surgery244 Westchester Avenue, Suite 209
West Harrison, NY 10604
Phone
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