Stenosis means "narrowing." Lumbar spinal stenosis is a narrowing of the spaces in the lower spine that puts pressure on the nerves traveling through. It's one of the most common reasons older adults have lower-spine surgery, and it develops slowly over years.
Symptoms — the classic pattern
The hallmark is neurogenic claudication: pain, heaviness, cramping, numbness, or tingling in the buttocks and legs that comes on with standing or walking and is relieved by sitting or bending forward. Many people notice they can walk much farther leaning on a shopping cart, or feel better walking uphill or biking — all positions that bend the spine forward and open up space for the nerves.
How it's diagnosed
The "better when sitting or bending forward" history plus a physical exam, with MRI showing the narrowing. Your doctor may also check leg circulation, since poor blood flow can mimic these symptoms (but that type eases with rest, not a change in position).
Treatment
Many people manage stenosis for years without surgery — physical therapy (often gentle forward-bending exercises), medicines, activity changes, and injections. Surgery is considered when symptoms are severe or don't improve, especially when walking and quality of life are significantly limited. The main operation is a laminectomy (decompression) to create more room; sometimes a fusion is added if there's also slippage or instability, though many do well with decompression alone.
You have loss of bladder or bowel control, saddle numbness, or rapidly worsening leg weakness.
Neurogenic claudication
This isn't a separate disease — it's the name for the main symptom pattern caused by lumbar spinal stenosis (above). "Neurogenic" means "coming from the nerves," and "claudication" means "leg discomfort with walking." Patients hear the term often, so it's worth explaining on its own.
Symptoms
Leg pain, cramping, heaviness, numbness, or weakness that comes on with walking or standing and eases when you sit or lean forward. It's often mistaken for a circulation problem — but the key difference is that nerve-related leg pain improves with a change in position (bending forward), while circulation-related leg pain improves simply with rest.
Diagnosis and treatment are the same as lumbar spinal stenosis, and distinguishing it from poor circulation is a key part of the evaluation.