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🏥 Gotokuji Orthopedic Clinic / Patient Guide

Lumbar Spinal Stenosis

Lumbar Spinal Canal Stenosis
Leg numbness while walking ("intermittent claudication") is the hallmark

This is a condition where the spinal canal (the passageway for nerves inside the spine) becomes narrow, squeezing the nerves that pass through it.
The hallmark symptom is intermittent claudication -- after walking for a while, your legs go numb and you cannot walk further, but leaning forward and resting brings relief and you can walk again.
It is a common lower-back condition in older adults.

1
Age-related changes around the spinal canal

Bones and ligaments thicken, and discs bulge, making the spinal canal narrower

2
Nerves get compressed

The nerves inside the narrowed canal are squeezed

3
Symptoms appear when standing and walking

Standing and walking narrow the canal further, causing leg numbness and pain

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Leaning forward brings relief

Bending forward opens up the spinal canal and eases pressure on the nerves

👴 Older adults 🔴 Spinal degeneration
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Legs go numb after walking for a while, making it hard to continue
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Leaning forward and resting brings relief, then you can walk again
Pain or numbness from the buttocks down to the legs
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Heavy, stiff feeling in the lower back
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Pain Medication
Loxonin or Acetaminophen to reduce pain. Loxoprofen must not be used if you have a peptic ulcer or have ever had an asthma attack triggered by a painkiller (aspirin-induced asthma)
Nerve Pain Medication
Tarlige or Lyrica to ease numbness and nerve pain
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Opalmon
Improves blood flow to help you walk longer distances. Please tell us if you take blood-thinning medication
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Physical Therapy
Core and hip strengthening exercises, plus guidance on comfortable walking
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Nerve Block Injection
Medication injected near the nerve when oral drugs are not enough
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Surgery
An operation to widen the spinal canal if conservative treatment does not help. We do not perform surgery here, so we refer you to a partner hospital
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Improvement is often possible with medication and physical therapy

We evaluate how well the medication works over 2-4 weeks and adjust the dose as needed. Combining medication with physical therapy often makes improvement easier to notice. If improvement is limited, we consider nerve blocks or surgery.

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Symptoms that need immediate attention
Sudden leg weakness, trouble with urination or bowel movements, or numbness in the groin area may indicate "cauda equina syndrome," which requires urgent medical care.

💡 Daily Life Tips

  • Using a shopping cart or bicycle (leaning-forward posture) tends to cause fewer symptoms
  • Lyrica and Tarlige can cause drowsiness and dizziness, so please avoid driving while taking them. Never adjust your dose on your own -- talk to your doctor first
  • Keep up with core and hip strengthening exercises
  • If the distance you can walk keeps getting shorter, please see us as soon as possible