What is spinal stenosis?
Spinal stenosis is a narrowing of the spaces in your spine that can put pressure on the spinal cord or the nerves that branch from it. It most commonly affects the lumbar spine (lower back), though it can also occur in the cervical spine (neck). The classic lumbar stenosis symptom is leg pain or cramping that comes on with walking and is relieved by sitting or bending forward (called 'neurogenic claudication'). It develops gradually and is most common in people over 60. PT can significantly improve function and quality of life — and many people avoid surgery.
Common symptoms
- Leg pain, cramping, or heaviness with walking that's relieved by sitting
- Numbness or tingling in the legs or feet
- Lower back pain, especially with standing or walking
- Symptoms that improve when you bend forward (leaning on a shopping cart helps)
- Difficulty walking long distances
- Weakness in the legs
- Less commonly: bladder or bowel changes (a red flag — see a doctor immediately)
- Symptoms that have come on gradually over months or years
What causes spinal stenosis?
Spinal stenosis is almost always caused by age-related changes in the spine — bone spurs from arthritis, thickened ligaments, bulging discs, or facet joint enlargement that all narrow the spinal canal. Less commonly it can be caused by a herniated disc, spinal injury, or congenital narrow canal. The narrowing itself doesn't always cause symptoms — it depends on whether nerves are actually being compressed and inflamed.
How physical therapy helps with spinal stenosis
Evaluation. Your first visit is an evaluation over video. Your PT takes a careful history (when it started, what positions help or hurt, walking tolerance), screens for red flags (bladder/bowel changes need immediate medical attention), tests strength and sensation in the legs, and assesses how you move.
Treatment. Your program is typically built around exercises that open up the narrowed spinal spaces — flexion-based exercises, hip mobility, and core strengthening. Walking with intervals (sit when symptoms come on, then continue) helps build tolerance. Aerobic conditioning (often on a stationary bike, which keeps the spine flexed) maintains fitness without aggravating symptoms. Posture and movement education helps with daily activities.
Ongoing support. Stenosis is a chronic condition that you manage rather than cure, but most patients see significant improvement in function and pain. Message your PT between visits about flare-ups, exercise modifications, or activity progressions. The plan evolves as your tolerance grows.
What to expect
Your first visit is about 60 minutes over video. Your PT screens for red flags, asks detailed questions about your walking tolerance and what positions help, and starts you on flexion-based exercises plus a walking program. Most patients see meaningful improvement within 6–12 weeks, with continued gains as walking tolerance and core strength build. Severe cases — significant weakness, progressive symptoms, or bladder/bowel changes — may need surgical consultation, and your PT will let you know if that's relevant.
Insurance accepted for spinal stenosis
Physical therapy for spinal stenosis is covered by most major insurance plans. You pay your normal copay — nothing extra for virtual visits.
MedicareBlue Shield of CaliforniaAnthem Blue CrossCignaAetnaUnited HealthcareHumana
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