Back & ribs
Lumbar spinal stenosis
Leg symptoms that build while standing or walking
What it means
Lumbar spinal stenosis is narrowing around nerves in the low back. Neurogenic claudication is the pattern of leg discomfort, heaviness, or numbness that can build with standing or walking and ease with sitting or bending forward. Blood flow problems can also cause walking-related leg symptoms. [1, 2]
What I check in the clinic
I ask how far you can walk before symptoms start and what you have to do to settle them. With a safe walking baseline, we can track how a change in pace, position, or a planned break affects the time you can stay on your feet.
What the evidence says about care
Evidence supports a course of care that combines education and exercise, sometimes with manual therapy, for selected people with neurogenic claudication. Surgery and nonsurgical care each deserve discussion in context. In one comparative trial, substantial crossover made it harder to isolate the effect of each option. [3, 4, 5]
Common questions
Why can I shop with a cart longer than I can walk down the block?
I’d ask what the cart changes for you, like support, pace, or when you stop. We can compare how each walk feels, using the rest of your history and exam to guide what we check.
How can we track progress when my walking distance varies every day?
Pick a familiar route and note when you first want a break and what helps you continue. Similar conditions make it easier to compare one walk with another.
Why do my legs feel heavy waiting in line but settle when I sit down?
Tell me how long you can stand and what changes when you sit. That pattern is worth comparing with what happens when you walk and what the exam shows.
What if I can get to the mailbox but still need to stop before I get home?
That gives us a specific goal. I’d ask what happens on the return trip and use a repeatable walking task to see what changes as we build toward it.
Can an MRI tell me whether the narrowing is causing my symptoms?
The scan helps describe anatomy. Your symptom pattern, examination, and sometimes other testing help determine whether it explains what happens when you walk. [1]
What should I bring to an evaluation?
Bring one example of a movement or activity you want back, along with any relevant imaging or treatment notes you already have.