Lumbar Spinal Stenosis: The No-Fluff Guide
By Dr. Rajesh, Trusted Spine Surgeon in London
If walking feels like a chore
If standing too long brings back pain and leg weakness
And sitting is the only way to find relief
There's a high chance you're dealing with Lumbar Spinal Stenosis.
As a spine surgeon in London, I see hundreds of cases each year-and the good news? With the right treatment plan, most patients return to normal life without surgery.
This guide breaks down:
- What lumbar stenosis really is
- Symptoms to watch out for
- Common causes & early signs
- Effective treatments (non-surgical & surgical)
- When surgery is the right step
What Is Lumbar Spinal Stenosis?
Stenosis = narrowing. Lumbar = lower back. Together, it means the space inside your lower spine is narrowing, compressing nerves that go to your legs.
The space in your lower spine that contains your spinal nerves gets narrower - either due to aging, wear-and-tear, or structural issues like a previous slipped disc or spine surgery - causing pressure on the spinal nerves that go to your legs.
Most Common Symptoms of Lumbar Stenosis
Here's what most of my patients in London describe:
- Back pain that comes and goes
- Leg numbness or heaviness when walking
- Relief when sitting or leaning forward
- Cramping or weakness in the legs
- Difficulty standing for long periods
This condition can mimic sciatica but often affects both legs. That’s a key distinction.
🛑 If you're feeling numb in your saddle region or losing bladder/bowel control—seek immediate help. This could be cauda equina syndrome, a surgical emergency.
What Causes Lumbar Stenosis?
Here are the top causes I see in clinic:
- Degenerative changes: Aging thins discs, thickens ligaments, swells joints.
- Herniated disc: Disc pushes into the nerve space.
- Thickened ligaments: Age-related stiffening narrows canal.
- Spondylolisthesis: Slipped vertebra leads to compression.
How I Diagnose Lumbar Stenosis at My Back Pain Clinic in London
🩺 Step 1: Clinical Evaluation
We discuss your pain pattern, walking distance, postural changes, and any weakness or numbness you experience during daily activities.
🧠 Step 2: Physical Exam
I assess your flexibility, spinal alignment, muscle strength, reflexes, and any areas of altered sensation like tingling or numbness.
🧲 Step 3: Imaging
- MRI: Gold standard. No radiation. Shows nerves and soft tissues in detail.
- X-ray: Helps assess spinal alignment, especially while standing.
- CT Scan: Occasionally used to understand bony anatomy more clearly.
Effective Treatment Options
Conservative (Non-Surgical)
- Physiotherapy — posture correction and strengthening
- Anti-inflammatory drugs, neuropathic agents
- Spinal injections — reduce inflammation, enable rehab
When Surgery Is Recommended
- No response to conservative treatment after 3–6 months
- Worsening pain and stiffness
- Progressive leg weakness
- Decrease in your walking distance before you have to sit down due to pain
- Numbness in your legs after you have walked some distance
- Confirmed severe stenosis on MRI
Surgical Options
- Decompression (Laminectomy): Remove bone/tissue to free nerves
- Fusion: For instability caused by vertebral slippage
Recovery Timeline
| Treatment | Return to Light Activity |
|---|---|
| Physiotherapy | 4–6 weeks |
| Spinal Injection | 1–2 weeks |
| Decompression Surgery | 4–6 weeks |
| Decompression + Fusion | 4–8 weeks |
How to Prevent Worsening
🧘 Regular spine-safe movement
🏃 Gentle walking or swimming
💺 Avoid long sitting or standing
📏 Core strengthening
⚖️ Maintain healthy weight
🪑 Ergonomic seating, standing desks if needed
Real Patient Testimonials
Priya S., London: “Dr. Rajesh diagnosed my spinal stenosis quickly and helped me recover without surgery. Highly recommend!”
David K., London: “After months of leg pain, I finally found relief. Dr. Rajesh was kind, clear, and extremely skilled.”
Book a Consultation with Dr. Rajesh
Expert diagnosis and step-by-step guidance for your spine health.
Frequently Asked Questions
Can lumbar stenosis heal naturally?
Mild cases can improve with lifestyle changes and physiotherapy. Surgery is usually needed only if symptoms are severe or worsening.
Is lumbar stenosis the same as sciatica?
No. Stenosis usually affects both legs and worsens with standing. Sciatica often affects only one leg and is caused by a herniated disc.
How long is recovery after surgery?
Most patients begin walking the same day or the next day after surgery. Light activity typically resumes within 2–4 weeks, depending on the procedure.
