Spinal Stenosis

Does this sound like you?

Most people have several of these, not all of them.

• Leg pain, heaviness or cramping that builds the longer you walk
• Rapid relief on sitting or bending forward
• Better walking uphill or pushing a trolley than walking upright
• Pins and needles or numbness in both legs
• Steadily reducing walking distance over months or years

Why it happens

• Age-related thickening of ligaments and enlargement of the facet joints
• Disc height loss narrowing the space further
• Previous spinal injury or surgery
• A congenitally narrower canal, which brings symptoms on earlier

What we would do about it

Roughly in this order — each step waits for the one before it.

1. Flexion-based exercise, which opens the space and is well supported by evidence
2. Progressive walking programs using intervals rather than pushing into pain
3. Hip and trunk strengthening to reduce the load through the spine
4. Manual therapy to the stiff segments and the hips
5. Cycling or water-based work as an alternative aerobic route
6. Referral for a surgical opinion where walking distance keeps falling despite all of it