Lumbar Stenosis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Lumbar Stenosis?
A neurosurgeon, a surgeon who treats the brain and spine, or an orthopedic doctor, a bone and joint doctor, often treats lumbar stenosis. A primary care doctor can start the evaluation. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is lumbar stenosis?
The lumbar spine is the lower back. Lumbar spinal stenosis is a narrowing of the spinal canal, which squeezes the nerves that travel through the lower back into the legs.
It may affect younger people because of developmental causes. It is more often caused by wear over time. It typically affects people age 60 and older.
Symptoms
Symptoms may include:
- Pain, weakness, or numbness in the legs, calves, or buttocks.
- Cramping in the calves with walking, so you need frequent short rests to walk a distance.
- Pain that spreads into one or both thighs and legs, like sciatica.
- Pain that may improve with bending forward, sitting, or lying down.
- In rare cases, loss of leg movement or loss of normal bowel or bladder function.
Narrowing may or may not cause symptoms. For most people, symptoms develop and get worse slowly over time.
Causes and who gets it
Narrowing of the spinal canal usually happens slowly, over many years or decades. With aging, the disks become less spongy and lose height. A hardened disk may bulge into the spinal canal. Bone spurs may also form and ligaments may thicken.
Symptoms may be due to inflammation, compression of the nerves, or both.
Aging and age-related changes in the spine are the most common causes of spinal stenosis. Arthritis is also a common cause. Some people are born with a small, narrow spinal canal.
How doctors diagnose it
A doctor makes the diagnosis. The doctor uses your history, symptoms, physical exam, and test results. Imaging tests, which make pictures of the body, may include:
- X-ray, which can show the bones, the alignment of the spine, and the joints.
- CT scan, which can show the shape and size of the spinal canal.
- MRI, which can show the spinal cord, nerve roots, and nearby areas.
- Myelogram, which uses contrast dye injected into the spinal fluid space to outline the nerves and spinal cord.
Treatment
Time, medicines, good posture, stretching, and exercise can help many people during pain flare-ups.
- Anti-inflammatory medicines can reduce swelling and pain, and pain relievers can ease pain.
- Epidural injections of medicine may be prescribed to help reduce swelling.
- Physical therapy or set exercises may help protect the spine and make you stronger and more flexible.
A doctor may recommend surgery if non-surgical care does not improve symptoms. The most common surgery in the lumbar spine is decompressive laminectomy. It removes the roof of the vertebrae to make more space for the nerves.
In a small percentage of patients, spinal instability may require spinal fusion. Spinal fusion is an operation that creates a solid union between two or more vertebrae.
There is no guarantee that surgery will help every person. The benefits of surgery should be weighed carefully against the risks of surgery and anesthesia.
When to see a doctor
See a doctor if you have pain, weakness, or numbness in your legs, calves, or buttocks.
Call 911 or go to the emergency room right away if you cannot pass urine or cannot hold it, or have numbness between your legs or over your buttocks, or if leg weakness or numbness is severe or getting worse. These can be signs of cauda equina syndrome, a rare medical emergency.
Surgery may be considered if progressive nerve problems develop, such as leg weakness, foot drop, or numbness in the limb.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can examine your back and legs, order imaging, start nonsurgical care, and refer you to a spine specialist if needed.
Common questions
Is lumbar stenosis the same as lumbar spinal stenosis?
Yes, they describe the same condition. Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back.
What does lumbar stenosis feel like?
Often it causes pain, weakness, or numbness in the legs, calves, or buttocks. You may also have cramping in the calves with walking.
Does sitting or bending forward help lumbar stenosis?
Often, yes. Pain may improve with bending forward, sitting, or lying down.
Who gets lumbar stenosis?
It is most often a condition of people age 60 and older. It may affect younger people because of developmental causes.
Does lumbar stenosis always need surgery?
No. Time, medicines, good posture, stretching, and exercise can help many people. A doctor may recommend surgery if non-surgical care does not improve symptoms.
Sources
- American Association of Neurological Surgeons - Lumbar Spinal Stenosis
- NIAMS - Spinal Stenosis
- OrthoInfo (AAOS) - Cauda Equina Syndrome
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
