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Neurology and Neurosurgery

Your questions about spinal stenosis treatments, answered

Adults of different ages and ethnicities laying on an exercise ball with an arm extended, stretching their back, which can help to prevent spinal stenosis or lessen symptoms from this common back condition.

08/14/2025

Here’s your guide to spinal stenosis causes, symptoms and treatments — from home care to the newest surgery options for nerve pain relief.

By Joshua Marcus, MD, Chief of Neurosurgery, Norwalk Hospital, part of Northwell Health

Living with spinal stenosis can make daily activities challenging. This common condition causes the spinal canal to narrow, which can put pressure on the spinal cord and nerve roots. The result can be back pain, nerve pain radiating to the arms or legs, muscle weakness, tingling or numbness. Simple things like walking long distances, bending or standing for extended periods may become difficult.

This guide will walk you through spinal stenosis causes, symptoms, risk factors, diagnosis, treatments and recovery, including the newest surgical option for people who need long-lasting relief.

Learn more about back and spine surgery at Nuvance Health Neuroscience Institute.

What is spinal stenosis?

Spinal stenosis is a condition where the spaces within the spinal canal become narrower, which can compress the spinal cord or nerve roots. It most commonly affects the lumbar spine (lower back) and sometimes the cervical spine (neck). Depending on the location and severity, stenosis can cause pain, numbness, tingling or muscle weakness in the arms or legs because of the pressure on the spinal nerves.

What causes spinal stenosis?

Age-related degeneration is the most frequent cause of spinal stenosis. Wear-and-tear over time can lead to osteoarthritis, which thickens ligaments and causes bone spurs that narrow the spinal canal. That’s why lumbar spinal stenosis is most common among adults over 50.

Herniated discs: Discs are gel-like cushions between each vertebra in the spine. A bulging or ruptured disc can press on the spinal cord, causing narrowing and stress on the nerves.

Bone spurs: Bone spurs are abnormal growths in the spine. Degeneration from aging or repetitive motions, osteoarthritis and spinal trauma can cause bone spurs. Like a disc herniation, a bone spur can push on the spinal canal and narrow it.

Thickened ligaments: Ligaments in the spine can stiffen and enlarge, reducing space in the canal.

Spinal injuries: Trauma can displace bone or tissue into the spinal canal.

Are there risk factors for spinal stenosis?

Age: The main risk factor for spinal stenosis is age because of the wear-and-tear on the spine over time. The risk of developing spinal stenosis increases after age 50.

Arthritis or degenerative spine conditions: Degeneration of the spine (spondylosis) affecting the discs, facet joints and ligaments can contribute to stenosis.

Sports: A history of sports that stress the spine can increase your risk of developing spinal stenosis, like football, gymnastics, weightlifting and wrestling.

Sedentary lifestyle: Prolonged sitting can compress the spine. Inactivity can also cause stiffness in the back and lead to deceased spinal mobility and flexibility.

Previous spinal injury or surgery: Scar tissue or structural changes from spinal cord injuries or surgeries can narrow the canal.

Congenital spine structure: Some people are born with a naturally narrow spinal canal.

What does spinal stenosis feel like?

Some people may not experience any symptoms from spinal stenosis. If narrowing of the spine causes symptoms, they may vary depending on the affecting level.

Symptoms of lumbar (lower spine) spinal stenosis:

Lower back pain: Aching or burning sensations that worsen with standing or walking.

Leg pain: Nerve compression can cause radiating pain in the legs. Lumbar spinal stenosis commonly irritates the sciatic nerve, causing sciatica or sharp pain that can run down the legs.

Muscle weakness in the legs or feet: Difficulty walking, climbing stairs or lifting the foot (foot drop) can result from irritated nerves in the lumbar spine.

Numbness or tingling in the lower body: Compressed nerves can cause numbness or the “pins and needles” feeling in the buttocks, thighs, calves or feet.

Positional pain: Positions that further compress the spine can aggravate symptoms. Typically, back extension or side bends and twisting are unfortunate for people with spinal stenosis.

Symptoms of cervical (neck) spinal stenosis:

Neck, back and arm pain: Nerve compression in the neck can cause radiating pain in the neck, upper back and down the arms.

Muscle weakness in the arms and hands: The nerves in the cervical spine run down the upper back and arms. When these nerves are distressed, they can’t send the appropriate signals to these parts of the body.

Numbness or tingling in the upper body: Like lumbar spinal stenosis, compressed nerves can cause numbness or a prickly feeling in your arms or hands.

How is spinal stenosis diagnosed?

Spinal diagnosis begins with a medical history. During the physical exam, your doctor will ask you about your symptoms and what makes them worse or better. It can be helpful to keep a log of these things to review with your doctor.

Then, your doctor will give you a physical exam. They will check your reflexes, balance and strength.

Imaging studies are also an important part of a spinal stenosis diagnosis:

X-rays show changes in vertebrae and loss of disc height.

CT scans help visualize bone spurs and stenosis severity.

MRIs show detailed images of the spinal cord, nerve roots and soft tissues.

Early diagnosis helps create a treatment plan before symptoms become disabling.

Can you stop spinal stenosis from progressing?

While you can’t reverse natural aging, you can slow progression by:

Staying active for flexibility and strengthening. Gentle, low-impact exercises like swimming, walking, Pilates and yoga can strengthen the core and improve flexibility and posture.

Maintaining a healthy weight reduces stress on the spine.

Addressing osteoporosis to keep your bones strong. Your doctor may recommend a diet full of calcium, vitamin D and protein, supplements or medications to keep your bones strong.

Following prescribed therapy may slow the progression of spinal stenosis and improve posture and spinal stability.

What should you avoid doing if you have spinal stenosis?

Certain body positions and lifestyle habits can worsen spinal stenosis symptoms, depending on where the narrowing in the spine is occurring.

High-impact activities like running or heavy lifting can increase pain.

Prolonged back extension: Leaning backward narrows the spinal canal and worsens symptoms.

Neck strain: Long periods of scrolling on mobile devices or staring can irritate symptoms from cervical spinal stenosis.

Twisting motions: Sudden or repetitive twisting can irritate compressed nerves.

Prolonged sitting: Sitting for long periods of time can compress the lumbar spine, tighten hip flexors and hamstrings, which all put tension on the lower back.

Ignoring pain: Pushing through nerve pain can lead to further nerve irritation or injury.

What are treatments for spinal stenosis?

Spinal stenosis treatments depend on the location in the spine and severity of your symptoms.

Seeing your primary care provider is usually the best first step for an initial evaluation. They can offer treatment options and connect you with additional care if needed, like physical therapy, interventional pain management or a spine specialist.

Treatments to manage mild spinal stenosis symptoms

Home remedies like heat therapy, over-the-counter anti-inflammatory medications and topical treatments and gentle stretching can relieve discomfort from spinal stenosis.

Physical therapy can strengthen core muscles, improve flexibility and reduce nerve pressure. Your doctor or rehabilitation team may also recommend an exercise program to help reduce nerve pressure and strengthen your core, like the bird dog and planking.

Treatments to manage moderate spinal stenosis symptoms

In addition to the above therapies, your doctor may recommend interventional pain management to relieve nerve pain. Some options could include:

Epidural steroid injections to reduce inflammation and provide temporary pain relief.

Prescribed medications like anti-inflammatory drugs or nerve pain medications.

Learn more about pain management options in this guide for people with chronic pain.

Treatments to manage severe spinal stenosis symptoms

When nerve pain and muscle weakness are unbearable and make it difficult to walk, sleep, work or simply complete essential daily tasks, surgery may be an option for you. Decompression surgery or spinal fusion can relieve nerve pressure. Continue reading to find out when surgery is the best treatment option for spinal stenosis and what are the latest procedures.

At what point does spinal stenosis require surgery?

A spine specialist, like a neurosurgeon, may recommend spine surgery for spinal stenosis when:

Symptoms persist despite months of non-surgical treatment.

Pain or weakness affects walking, balance or daily life.

Numbness or motor weakness progresses, increasing the risk for irreversible nerve damage.

When lumbar spine stenosis causes bowel or urinary incontinence.

Your surgeon should evaluate your imaging, symptoms and lifestyle goals to recommend the best spinal stenosis treatment for you.

What is the newest treatment for spinal stenosis?

The Nuvance Health neurosurgery team performed Connecticut’s first facet joint replacement using the Total Posterior Spine Surgery (TOPS™) system in September 2023. Since then, the team has performed nearly the most TOPS procedures in the country. TOPS offers new hope to people with spinal stenosis and spondylolisthesis (slipped vertebra) because it preserves mobility while relieving pressure on the spine — an advancement beyond traditional spinal fusion surgery.

Learn more: Nuvance Health first in Connecticut to perform new spine surgery for spinal stenosis and spondylolisthesis

In addition to TOPS, there are several minimally invasive decompression and stabilization procedures for spinal stenosis. These approaches require smaller incisions and patients benefit from shorter hospital stays, less postoperative pain, and faster recovery and return to activity.

Other options for spinal stenosis surgery include:

Laminectomy: During a laminectomy, your surgeon will remove the lamina, which is the back part of the affected bone. Sometimes, spinal fusion is also required if the spine needs hardware to stabilize it. Your surgeon will fuse the vertebrae in the affected area together using a bone graft and metal hardware.

Laminotomy: During a laminotomy, your surgeon will remove only a portion of the lamina.

All these decompression spinal surgeries aim to relieve pressure on the nerves to alleviate pain and restore muscle strength and normal sensation in the arms or legs.

How long does it take to recover from back surgery for spinal stenosis?

How long you stay in the hospital after surgery depends on the type of operation you have and your overall health. Thanks to advancements in surgical interventions, many people can go home the same day (outpatient) or only require a one- or two-day hospital stay.

Recovery at home also depends on the type of surgery you had, how severe your symptoms were before and your overall health.

Most people experience nerve pain relief right after surgery, and they can return to light activities a couple weeks after surgery.

Muscle strength, numbness and tingling should gradually improve three months after surgery, although it can take a full year to regain strength and normal sensations. There’s no way to know for sure how much function you will gain back, but sticking to a prescribed exercise and rehab program can increase your chances of a full recovery. Following your rehab plan is key to regaining strength, mobility and confidence.

The bottom line: Spinal stenosis can significantly impact daily life, but modern treatments — including minimally invasive surgery — offer effective relief. Recognizing symptoms early, following conservative care and seeking neurosurgical evaluation when needed can help you stay active and enjoy a better quality of life.