Patient information · adults
Lumbar spinal stenosis and neurogenic claudication
A clear explanation of why narrowing around the lumbar nerves may limit walking and how symptoms, neurological examination and imaging are considered together.
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What lumbar spinal stenosis means
The spinal canal and its side recesses contain the nerve roots travelling to the legs. Changes in discs, joints and ligaments may reduce the available space. An MRI description of narrowing alone does not establish whether it is causing symptoms.
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What neurogenic claudication may feel like
Pain, heaviness, tingling, numbness, fatigue or weakness in one or both legs may worsen during standing and walking. Sitting or leaning forwards may help. Similar symptoms can also have vascular, joint, muscular or other neurological causes.
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How the MRI finding is assessed
Assessment brings together the symptom history, walking tolerance, neurological examination and imaging. Strength, sensation, reflexes and gait are considered alongside other possible causes. Imaging should fit the side, level and pattern of the symptoms.
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Treatment options
When there is no emergency, care may include education, individually selected activity and rehabilitation, and symptom treatment appropriate to the person. Evidence varies between interventions, so goals and response should be reviewed.
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When decompression may be discussed
Surgery may be considered when important symptoms continue, walking or function remains substantially restricted, and the clinical findings agree with imaging despite appropriate non-operative care. Decompression aims to make more room for nerves, but it does not treat every cause of back pain or guarantee a particular outcome.
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Questions for a consultation
Do my symptoms fit neurogenic claudication? What alternative causes need assessment? Does the MRI narrowing match my symptoms? How will changes in walking and function be measured? What are the realistic benefits, limitations and risks of each option?