Musculoskeletal Condition · Glastonbury, CT

Lumbar Spinal Stenosis

Lower-spine narrowing causing leg pain or cramping with walking: non-surgical options and when to consider surgery with Dr. Paul Tortland, DO.

Written and clinically reviewed by

Paul D. Tortland, DO, FAOASM, CAQSM, RMSK

Dr. Paul Tortland, DO is a non-surgical orthopedic & sports medicine physician specializing in regenerative orthopedics and surgical alternative treatment. He is dual board-certified in Sports Medicine & Osteopathic Manipulative Medicine (OMM) and Regenerative Medicine, Fellowship-trained in Sports Medicine. He became the first physician in the world to earn board certification in Regenerative Medicine in 2015. Diplomate, American Board of Regenerative Medicine (ABRM), 2015. Registered in Musculoskeletal Ultrasound (RMSK).

Condition

What is lumbar spinal stenosis?

Spinal stenosis means the tunnel that holds your nerves has narrowed, so your legs feel heavy, tired or cramped when you stand or walk. Sitting or leaning forward usually eases it. Care starts with rehab and, if needed, a targeted injection. Dr. Paul Tortland, DO, will tell you if worsening weakness means you should see a surgeon.

Explore related conditions: Browse the Back and spine condition hub for related diagnoses and treatment options.

CARE OPTIONS

What are treatment options for lumbar spinal stenosis?

Dr. Tortland’s potential treatment options: Dr. Tortland can evaluate musculoskeletal contributors but lumbar spinal stenosis requires assessment of nerve and spine symptoms before choosing treatment. PRP treatment or other regenerative injections do not reliably reverse a narrowed spinal canal and should not replace a spine evaluation when nerve compression is suspected.

Physical therapy and traditional care: Traditional care may include physical therapy, walking or cycling in a tolerated position, trunk and leg strengthening, activity modification, and medication if safe. A spine specialist may discuss epidural injections or other options based on symptoms and imaging.

When other care may be needed: Progressive leg weakness, numbness in the saddle region, or loss of bladder or bowel control is an emergency. Severe walking limitation or worsening neurologic symptoms warrant timely spine-specialist assessment.

Common questions

Questions about lumbar spinal stenosis

What causes lumbar spinal stenosis?

Lumbar spinal stenosis is a narrowing of the spinal canal, usually from age-related changes such as disc bulging, facet joint arthritis, and thickened ligaments. These changes can crowd the nerves in the lower back.

What are the symptoms of lumbar spinal stenosis?

Common symptoms are leg pain, heaviness, or cramping with standing or walking that eases with sitting or leaning forward. Sudden weakness or loss of bladder or bowel control needs emergency care.

What are the non-surgical treatment options for lumbar spinal stenosis?

Options include physical therapy, flexion-based exercise, activity pacing, and image-guided epidural or joint injections. Surgical referral is considered when symptoms are severe, progressive, or limit daily function despite conservative care.

What regenerative options may help lumbar spinal stenosis?

Regenerative treatments are typically aimed at painful facet joints, ligaments, and irritated nerves around the stenosis, not at widening the canal. Evidence is still developing, and candidacy is determined after an exam and imaging review.