- Spinal stenosis
- Back pain
- Spine
Spinal stenosis: leg pain when you walk that eases when you sit
Spinal stenosis is a narrowing of the spine that puts pressure on the nerves. We explain its typical symptoms, its causes, and treatment options from physical therapy to surgery.
PainManagement ER Published 3 min read
You walk a few blocks and the burning or heaviness in your legs starts. You sit down or lean forward, for example on a shopping cart, and it eases. That’s a typical pattern of spinal stenosis, which according to the NIH happens when the spaces inside the spine narrow and put pressure on the spinal cord and nerve roots.[1]
Who gets it
Anyone can get it, but the chances increase with age. Younger people can have it too if they were born with a narrow spinal canal or had a spine injury. It is most common in the lower back and the neck.[1]
Symptoms
| Area | Symptoms (per NIAMS) |
|---|---|
| Lower back | Low back pain; burning pain or ache down the buttocks and legs that usually gets worse when standing or walking; numbness, tingling, cramping and weakness in the legs or feet |
| Neck | Neck pain; numbness or tingling into the arms and hands; weakness in the hand, arm or fingers |
Source: NIAMS, NIH (2023).[1]
Sitting or flexing the lower back or neck may relieve symptoms. Leaning forward usually eases leg pain, while standing or arching the back makes it worse.[1] In more severe cases there may be bowel, bladder or sexual function problems.[1]
Causes
According to NIAMS:[1]
- Aging: thickened ligaments, bulging disks, bone spurs and spondylolisthesis (a vertebra slipping forward).
- Arthritis: mainly osteoarthritis and, less commonly, rheumatoid arthritis.
- Inherited conditions: being born with a narrow canal, scoliosis or achondroplasia.
- Others: fractures from injuries, spinal tumors or Paget’s disease of bone.
How it is diagnosed
Your doctor asks about your symptom history and checks range of motion, whether symptoms change when you bend, nerve function, balance and walking. They may order an X-ray, MRI or CT scan. NIAMS notes that imaging alone does not determine whether treatment is needed.[2]
Non-surgical treatments
| Option | What it's for |
|---|---|
| Physical therapy | Maintaining motion, strengthening the back and abdomen, and building endurance; may include progressive aerobic activity such as swimming or a stationary bike, plus home exercises |
| Medications | Anti-inflammatories, over-the-counter pain relievers (oral or applied to the skin) and, for severe pain, prescription pain relievers |
| Injections | Anti-inflammatory or numbing injections for pain that radiates because a nerve is compressed or irritated |
| Bracing | Can add support and improve mobility in some cases |
| Complementary therapies | Spinal manipulation and acupuncture may relieve pain for some people |
Source: NIAMS, NIH (2023).[2] The right plan depends on each case.
When is surgery considered?
If symptoms continue despite treatment, your doctor may recommend seeing a surgeon. Surgery may be recommended sooner if there is numbness or weakness that interferes with walking, impaired bladder or bowel function, or other neurological problems.[2] According to NIAMS, most people who have surgery have less leg pain and walk better, although if the nerves were badly damaged some pain or numbness may remain.[2]
Living with spinal stenosis
NIAMS recommends:[2]
- Exercising at least 3 times a week for 30 minutes, adapting activities so they don’t make pain worse (check with your doctor first).
- Pacing activities and adjusting routines that trigger pain.
- Using walking aids if they help your stability.
- Trying posture changes: flexing the spine relieves some people.
- Keeping a healthy weight and quitting smoking.
If leg pain makes you stop every time you walk, an assessment can confirm whether it’s spinal stenosis and help keep you moving.
Sources
- Spinal Stenosis . National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH , reviewed November 2023.
- Spinal Stenosis: Diagnosis, Treatment, and Steps to Take . National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH , reviewed November 2023.
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