Leg pain and heaviness when you stand or walk.
Spinal stenosis is what happens when the channel your spinal cord and nerve roots travel through gradually narrows — pinching the nerves inside. The hallmark is pain or fatigue in the legs that builds when you're upright and eases when you sit or lean forward. It's a manageable condition, and most people do well without surgery.
Your doctor may describe this as narrowing of the spinal canal.
Often seen within a few days — sometimes as soon as tomorrowRequest your first visit
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What spinal stenosis really is.
Your spinal canal is the bony tunnel that runs down the center of your vertebrae, protecting the spinal cord and the nerve roots that branch off it. Stenosis means that tunnel has narrowed — usually because of age-related changes like thickened ligaments, bone spurs, or bulging discs gradually encroaching on the space available for the nerves.
The narrowing itself is slow and often silent for years. Symptoms emerge when the available space drops enough that the nerves inside are compressed when you stand or walk. Sitting or bending forward opens the canal slightly and relieves the pressure — which is why people with stenosis often notice they can walk farther if they lean on a grocery cart, or feel better climbing stairs than descending them.
The good news
Spinal stenosis is very common and very treatable. The narrowing rarely reverses, but the symptoms respond well to a combination of targeted physical therapy, injections, and — when needed — minimally invasive decompression procedures. Most people live actively and comfortably with the right ongoing care plan.
Neurogenic claudication
The classic presentation is neurogenic claudication — leg heaviness, cramping, or pain that builds with walking and resolves with sitting or flexion. We distinguish it from vascular claudication (same symptom pattern, different cause) and from disc-related radiculopathy by history, exam, and imaging. MRI defines the stenosis level and severity; an epidural steroid injection can both confirm the level and provide significant relief.
Common signs we treat.
Pain when standing or walking
Cramping, aching, or heaviness in the legs that comes on after standing or walking for a while — and eases quickly when you sit or lean forward.
Numbness in legs
A spreading numbness or tingling in one or both legs while upright — a sign the nerve roots inside the narrowed canal are under pressure.
Heaviness or weakness in the legs
Legs that feel weak or heavy after a short distance — as if they simply won't go on — even though you feel fine at rest.
From hurting to healed.
We work from the least-invasive options upward, escalating only if you need it. Most patients improve well before surgery is ever discussed.
Diagnose the cause
A physician examines you and, if needed, reviews imaging to pinpoint exactly what's driving the pain.
Calm it down
Targeted physical therapy, activity guidance, and medication to settle the irritation and reduce inflammation.
Image-guided injections
If pain persists, a precisely targeted injection delivered to the source under imaging.
Advanced options
For the few who need more, minimally invasive interventional procedures — with surgery as a last resort.
Treatment is matched to your specific diagnosis at your visit. The options shown reflect NASPAC's general approach and should be confirmed against the practice's verified procedure list.
Still have questions?
Most cases are degenerative — the result of normal aging changes in the spine. Over years, discs lose height, ligaments thicken and buckle inward, and bone spurs form around the joints. Individually each change is small; together they can meaningfully reduce the space available for the nerves. Less commonly, stenosis is congenital (a naturally narrow canal present from birth).
Standing and walking cause the spine to extend slightly, which causes the already-thickened ligaments to fold further into the canal and reduces nerve space. Sitting or bending forward reverses this, which is why the symptoms are so reliably posture-dependent. Leaning on a cart or walking uphill (which flexes the lumbar spine) often helps more than walking on flat ground.
Yes — most people do well without it. Physical therapy focused on flexion-based exercises and core stability, along with epidural steroid injections when needed, controls symptoms well for the majority of patients. Surgery is considered when symptoms are severe, limit function significantly, or include weakness — and even then, minimally invasive decompression options are often available.
Gradually, the anatomical narrowing tends to progress — but symptoms don't necessarily worsen at the same pace. Many people plateau and remain stable for years. The goal of ongoing care is to keep the symptoms manageable and your function high regardless of what imaging shows.
Stop living with the leg heaviness.
Book with a board-certified pain physician near you — most patients are seen within days.
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