Want to know more? Request a Callback
Or give us a call, to find out how we can help you with Lumbar Spinal Stenosis & Chiropractic Treatment.
Book an Appointment
Schedule an appointment for Lumbar Spinal Stenosis & Chiropractic Treatment tailored to your needs.
Lumbar spinal stenosis is a narrowing of the spaces within the lower spine which can affect the nerves travelling into the legs. It becomes more common as we get older and can cause back or leg pain, numbness, heaviness or weakness, particularly during standing and walking.
A characteristic feature is neurogenic claudication: symptoms in one or both legs that tend to increase with standing or walking and improve when sitting down or bending forwards.
At Isis Chiropractic Centres, we assess more than the scan. We consider your symptoms, neurological findings, walking ability, general health and the effect the condition is having on your everyday life.
Treatment is individualised and multimodal. Depending on your clinical findings, this may combine advice and education, manual therapy, exercise and rehabilitation and, where appropriate, other treatment options available within our clinics.
Lumbar spinal stenosis means that there is narrowing within part of the spinal canal or the spaces through which the spinal nerves pass in the lower back.
The narrowing is commonly associated with age-related changes including degeneration of the spinal joints and discs, enlargement of the facet joints and ligaments, and sometimes changes in the alignment of the vertebrae.
These changes can reduce the space available for the nerves.
However, an important distinction needs to be made between anatomical stenosis seen on a scan and symptomatic lumbar spinal stenosis. Imaging findings need to be interpreted alongside the patient’s symptoms and clinical examination.
Symptoms vary considerably between patients. Some people primarily experience leg symptoms, while others also have low-back pain.
Common symptoms can include:
Neurogenic claudication is one of the characteristic clinical presentations associated with lumbar spinal stenosis.
People may be relatively comfortable while sitting but develop pain, aching, numbness, heaviness or weakness in the buttocks or legs after standing or walking for a period of time.
Sitting or bending forwards often reduces the symptoms, allowing the person to walk again after a short rest.
This can gradually have a substantial effect on everyday life. Activities such as shopping, travelling, walking the dog or simply remaining on your feet can become increasingly difficult.
One of the important goals of treatment is therefore not simply to reduce pain, but to maintain or improve walking capacity, function and independence.
No. The two conditions can produce similar symptoms, but they are not necessarily the same problem.
Sciatica describes symptoms arising from irritation or compression of a lumbar nerve root, commonly producing pain, numbness or tingling that travels into the leg.
Lumbar spinal stenosis can affect several nerves and frequently produces symptoms during standing and walking. Symptoms may affect one or both legs.
A disc herniation, spinal stenosis and other conditions can all produce leg symptoms, which is why establishing the likely cause is important before deciding on treatment.
Assessment begins with understanding the pattern of your symptoms and how they affect your everyday activities.
We want to know what brings the symptoms on, how far you can walk or how long you can stand, what makes the symptoms better, whether you experience numbness or weakness and whether your walking ability has changed.
The physical examination may include assessment of spinal and hip movement, neurological function, muscle strength, reflexes, sensation and walking ability.
We also consider other possible causes of leg symptoms. For example, problems with circulation can also cause leg pain during walking and need to be distinguished from neurogenic claudication.
An MRI scan can demonstrate narrowing of the spinal canal and the openings through which the spinal nerves pass. Imaging may be appropriate when the diagnosis is uncertain, neurological findings are present, symptoms are progressing or the result is likely to influence treatment or referral.
However, treatment should not be based on an MRI image alone.
Degenerative changes and narrowing can be present on imaging without necessarily explaining all of a patient’s symptoms. We therefore interpret imaging alongside the history and clinical examination.
Many people with lumbar spinal stenosis and neurogenic claudication are initially managed without surgery.
Research supports a multimodal approach rather than relying on one treatment technique. Depending on the individual patient, conservative care may combine:
At Isis Chiropractic Centres, this fits closely with the way we manage persistent musculoskeletal conditions. Treatment is selected according to the patient’s symptoms, examination findings, abilities and goals rather than applying the same technique to everyone.
Chiropractic care at Isis should not be understood simply as spinal manipulation.
We are a multimodal practice. Depending on the individual patient, treatment may incorporate manual therapy, joint mobilisation or manipulation where appropriate, soft-tissue treatment, mobility work, exercise, rehabilitation, education and advice about maintaining activity.
The aim is not to claim that manual treatment physically removes the anatomical narrowing within the spinal canal.
Instead, treatment and rehabilitation focus on factors that may be improved, including movement, strength, physical capacity, walking tolerance and the patient’s ability to remain active and independent.
Research into conservative treatment for lumbar spinal stenosis increasingly supports a multimodal approach combining manual therapy, exercise, education and rehabilitation rather than relying on a single treatment technique.
A randomised controlled trial led by Carlo Ammendolia compared a structured six-week comprehensive non-surgical programme with self-directed care in people with lumbar spinal stenosis and neurogenic claudication. The comprehensive programme included manual therapy, exercise, education and strategies designed to improve walking ability. Improvements in walking capacity favoured the comprehensive programme, with benefits in walking performance still evident at follow-up.
Another randomised clinical trial involving 259 patients compared medical care, group exercise and manual therapy combined with individualised exercise. The manual therapy and individualised exercise group showed greater short-term improvements in symptoms and physical function and a greater proportion of patients improved their walking capacity. The differences between the groups were no longer significant at six months.
An updated systematic review published in 2022 concluded that there is moderate-quality evidence supporting a multimodal approach which includes manual therapy and exercise, with or without education, for lumbar spinal stenosis with neurogenic claudication.
A clinical practice guideline has similarly recommended that initial management can include multimodal non-pharmacological care incorporating education and advice, home exercise, manual therapy and rehabilitation.
This evidence is particularly relevant to the way we practise at Isis. It supports combining appropriate hands-on treatment with exercise, rehabilitation, education and strategies to improve walking and everyday function rather than relying on one treatment technique.
Exercise and rehabilitation are important parts of conservative management for many people with lumbar spinal stenosis.
The programme should be adapted to the individual rather than simply giving everyone the same set of exercises.
Depending on the patient’s needs, rehabilitation may include:
Supervised, individualised exercise can be particularly useful when pain or reduced walking ability has caused someone to become progressively less active.
IDD Therapy is a computer-controlled form of spinal distraction which may be considered as part of treatment for selected patients with lumbar spinal stenosis.
It is not appropriate for every patient with stenosis, and we would not recommend IDD simply because narrowing is visible on an MRI scan.
The decision depends on the patient’s symptoms, neurological findings, the nature and severity of the stenosis and the overall clinical picture.
Importantly, the stronger clinical evidence for conservative treatment of lumbar spinal stenosis relates to multimodal programmes incorporating exercise, rehabilitation, education and manual therapy, rather than IDD Therapy specifically.
Where we consider IDD appropriate, it can therefore be incorporated into the patient’s broader programme of care rather than replacing rehabilitation and active treatment.
Learn more about IDD Therapy →
Some people with lumbar spinal stenosis will require specialist assessment and may ultimately benefit from surgery.
Referral for a specialist opinion may be appropriate when symptoms are severe, neurological function is deteriorating, walking and everyday activities remain substantially restricted despite appropriate conservative treatment, or the clinical findings suggest that further investigation or surgical assessment is needed.
Our aim is not to delay surgery when surgery may be appropriate. It is to identify which patients can reasonably be managed conservatively and which patients require further investigation or specialist assessment.
Most lumbar spinal stenosis does not require emergency treatment. However, significant or progressive neurological changes require prompt assessment.
Go to A&E urgently if back or leg symptoms are accompanied by new:
These symptoms can indicate cauda equina syndrome and require immediate medical assessment.
If back or leg symptoms are making it increasingly difficult to stand, walk or remain active, the first step is to establish what is most likely to be causing the problem.
At Isis Chiropractic Centres, we take an individualised, multimodal approach. We assess your symptoms, neurological function, movement and walking ability and review any relevant imaging before discussing the treatment options that may be appropriate.
Your programme may include a combination of advice and education, manual therapy, exercise and rehabilitation and, where appropriate, additional treatment options available within our clinics.
As your symptoms and abilities change, the balance between different elements of treatment can also change. The aim is to progressively support greater activity and self-management rather than creating dependence on passive treatment.
Our aim is to help you improve or maintain your mobility, walking ability, function and independence.
Chiropractic treatment should not be presented as physically reversing the degenerative narrowing responsible for lumbar spinal stenosis. Conservative care instead aims to improve symptoms, movement, walking capacity and function.
Research supports multimodal conservative care incorporating manual therapy and individualised exercise for people with lumbar spinal stenosis and neurogenic claudication. At Isis, chiropractic care may therefore include manual treatment alongside exercise, rehabilitation, education and self-management rather than relying on manipulation alone.
Maintaining physical activity is generally important, but walking can provoke symptoms in people with neurogenic claudication. Rather than simply advising patients to walk through increasing symptoms, walking and exercise programmes can be adapted to the individual’s tolerance and progressively developed as capacity improves.
People with lumbar spinal stenosis frequently find that sitting or bending forwards reduces their leg symptoms. Flexing the lumbar spine can increase the available space within parts of the spinal canal and nerve openings, which may help explain why some people can cycle more comfortably than they can walk or find that leaning over a shopping trolley allows them to walk further.
No. The course of lumbar spinal stenosis varies between individuals. The presence of degenerative narrowing on a scan does not by itself determine how symptoms will progress. Changes in walking ability, neurological function and everyday activities are therefore important when monitoring the condition.
No. Many patients are initially managed conservatively. Surgery may be considered when symptoms remain significantly disabling despite appropriate conservative care or when neurological or other clinical findings make specialist assessment appropriate.
IDD Therapy may be considered for selected patients as one component of a broader treatment programme. However, the stronger research evidence for conservative management of lumbar spinal stenosis supports multimodal care incorporating exercise, rehabilitation, education and manual therapy rather than IDD Therapy specifically.
Clinical content reviewed by Per Kleberg BSc, DC, FRCC – Chiropractor
Per Kleberg has more than 30 years of clinical experience and is registered with the General Chiropractic Council.
Intervertebral Differential Dynamics (IDD) Therapy is a non-invasive, computer-controlled form of spinal decompression that may be considered for some patients with persistent back pain, neck pain, leg pain, disc-related problems or sciatica.
Back pain can have many causes. Learn how we assess back pain and use individualised treatment and rehabilitation to help improve movement and function.
Disc injuries can cause back pain, sciatica, numbness or weakness. Learn about assessment, treatment and rehabilitation options.
Sciatica can cause pain, numbness, tingling or weakness in the leg. Learn how we assess the likely cause and discuss appropriate treatment and rehabilitation options.