Pain Center
Spinal Stenosis
Narrowing of the spinal canal that compresses nerves and limits walking.
Overview
Understanding spinal stenosis.
Lumbar spinal stenosis is the gradual narrowing of the spinal canal — most commonly from age-related thickening of the ligamentum flavum, disc degeneration, and facet hypertrophy. The hallmark is neurogenic claudication: leg pain, heaviness, or numbness that comes on with walking or standing and improves with sitting, leaning forward, or using a shopping cart for support.
Stenosis is one of the most common conditions in patients over 60, and it is also one where outdated thinking still shapes treatment. For decades, patients with stenosis had two options: live with it, or undergo a laminectomy or fusion. The MILD procedure has changed that. For patients whose stenosis is driven by ligamentum flavum hypertrophy, MILD offers an outpatient, implant-free option that preserves the spine's natural anatomy.
We treat stenosis at every stage — from early symptomatic patients still benefitting from conservative care, to patients exploring MILD and other targeted procedures, to patients who have already had surgery and need ongoing management.
Common Symptoms
- Leg pain, heaviness, or numbness with walking or standing
- Relief from sitting or leaning forward (over a shopping cart)
- Reduced walking distance over time
- Low-back pain often present but not always dominant
Common Causes
- Ligamentum flavum hypertrophy
- Disc degeneration and facet arthropathy
- Spondylolisthesis
- Congenital narrowing
How we approach spinal stenosis.
Diagnosis & workup
- History — specifically the pattern of leg symptoms with walking and relief with sitting.
- Physical exam — neurologic assessment, gait, and key provocative tests.
- MRI of the lumbar spine to assess canal and foraminal narrowing and identify ligamentum flavum hypertrophy.
- Standing and flexion/extension X-rays in selected cases of suspected instability.
- Selective nerve-root injection if multiple levels of narrowing are present and we need to identify which is symptomatic.
When to see a specialist
- Walking distance progressively shrinking — limited to a city block or less.
- Leg symptoms (pain, heaviness, numbness) interfering with daily activities.
- Failed physical therapy or oral medications for stenosis-related symptoms.
- Prior epidural injections that helped only briefly.
- Surgeon recommended laminectomy or fusion — second opinion is reasonable.
What to expect over time.
Recovery from stenosis treatment depends on the intervention. Conservative care (physical therapy, oral medications, occasional injections) is ongoing — patients learn what flares their symptoms and how to manage. The MILD procedure is outpatient with most patients returning to normal activities within a few days, and improvement in walking distance progressing over 2–6 weeks. For patients who need surgery, we coordinate with a thoughtful spine surgeon and provide post-op pain management.
Direct answers — no jargon.
If your question isn’t here, ask us at your consultation.
- The classic pattern is leg pain, heaviness, or numbness that comes on with walking or standing and is relieved by sitting or leaning forward (over a shopping cart, kitchen counter, or walker). Some patients also have low-back pain, but the leg symptoms are usually what limits function.
How we treat spinal stenosis, differently.
We are not stenosis-by-default-injection providers. We carefully assess whether MILD is the right fit (it requires specific MRI findings), whether epidural injections will help, or whether surgical referral is the more honest answer. The MILD procedure is one of our areas of focus, and Dr. Baumgartner has performed it many times — but only for patients who are likely to benefit.
Other conditions we treat.
See all conditionsSciatica
Radiating leg pain from compression or irritation of the sciatic nerve.Learn moreBack Pain
The most common reason patients come to us — and where we have the most to offer.Learn moreHerniated Discs
When the soft inner disc material pushes through the outer wall and irritates a nerve.Learn moreNeuropathic Pain
Burning, electric, or tingling pain caused by injury or irritation of the nerves themselves.Learn moreMedically Reviewed
Reviewed by Edward Baumgartner Jr., MD · Last reviewed . Information on this page is not medical advice. Always consult your physician.
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