Spinal Stenosis Treatment

Spinal stenosis is a narrowing of the spaces within the spinal canal that puts pressure on the nerves traveling through the spine. It most commonly affects the lumbar spine and is typically associated with age-related degenerative changes, though it can occur at any level.

Common symptoms include:

• Pain, numbness, or weakness in the legs — especially with walking or standing
• Cramping or heaviness in the legs after walking short distances (neurogenic claudication)
• Relief when sitting down, bending forward, or leaning on a shopping cart
• Difficulty with balance and coordination, particularly on uneven surfaces
• Low back stiffness that worsens with prolonged standing

Many patients notice that symptoms improve when sitting or leaning forward, which temporarily opens the spinal canal. This pattern is a hallmark of stenosis and helps distinguish it from other causes of leg pain.

While spinal stenosis is a structural condition that physical therapy cannot reverse, the right exercise program and manual treatment can significantly reduce symptoms and improve your ability to walk, stand, and stay active. Many patients successfully manage stenosis without surgery through consistent, targeted physical therapy.

Our approach focuses on optimizing the space available in your spinal canal through targeted positioning, mobility work, and strengthening. Treatment at The Back Clinic typically includes:

• Flexion-based exercises — movements that open the spinal canal and reduce nerve compression
• manual therapy — hands-on techniques to restore joint mobility in the lumbar spine and hips
• Core and hip strengthening — building stability in the muscles that support and protect the spine
• Aquatic therapy — our heated pool allows pain-free movement and decompression in a buoyant environment, which is especially beneficial for stenosis patients
• Walking endurance training — gradually increasing your walking distance and tolerance through progressive exercise
• Balance and gait training — improving stability and coordination to reduce fall risk

Every session is one-on-one with a licensed physical therapist who understands the specific demands of treating stenosis. We tailor the intensity to your comfort level and adjust the plan as your tolerance improves.

Our goal is to maximize your walking distance, reduce leg symptoms, and help you maintain the active lifestyle you want — all through a structured, evidence-based approach that avoids unnecessary surgical intervention.

During your initial evaluation, your therapist will assess your walking tolerance, posture, flexibility, strength, and nerve function to understand how stenosis is affecting your daily life. We’ll explain what we find and outline a treatment plan focused on your specific goals.

Follow-up sessions are typically 30 minutes, 2–3 times per week. Many patients begin to notice improvement in walking distance and leg symptoms within the first 3–4 weeks, with continued gains over 8–12 weeks of consistent treatment.

Wear comfortable clothing and supportive shoes. Bring any imaging reports (MRI, X-ray) if available — these help us understand the extent of the narrowing but are not required to begin treatment.

In Delaware, you don’t need a referral to start physical therapy for the first 30 days. Most major insurance plans are accepted, including Medicare — which covers most of our stenosis patients. Our team can verify your benefits before your first visit.