Low Back & Pelvis

What It Is

Spinal stenosis is a narrowing of the space inside your spine (the spinal canal), which can put pressure on the spinal cord and the nerves that travel through it. It most often occurs in the lower back and the neck. Some people have no symptoms, but the condition can cause pain, muscle weakness, numbness and problems with the bowel or bladder (NIAMS, 2023a).

Spinal stenosis is most often caused by normal wear-and-tear changes in the spine that come with growing older. In severe cases, surgery might be needed to create more space for the nerves or spinal cord.

Spinal stenosis happens most often in adults over 60 and affects men and women equally. A small number of people are born with a narrow spinal canal (congenital spinal stenosis), which is more common in men (AAOS, n.d.). It can also follow an injury to the spine.

Possible Causes of Spinal Stenosis?

Inherited – some people are born with a small spinal canal or have a curvature of the spine (scoliosis) that puts pressure on nerves.
Osteoarthritis wears away the cartilage surface of joints, and is often accompanied by overgrowth of bone (bone spurs), which may narrow the spinal canal.
Rheumatoid arthritis – inflammation and enlargement of the soft tissues of the joints.
Tumours of the spine – abnormal growths that may affect the spinal canal.
Injury (trauma), such as from an accident.
Paget's disease of bone – a long-term disorder that typically results in enlarged and deformed bones.

(NIAMS, 2023a)

Spinal Stenosis Anatomy

The spine is made up of a number of small bones, called vertebrae, stacked one on top of the other. Ligaments, nerves, muscles and intervertebral discs are other parts of the spine.

The vertebrae connect to create a canal that shields and protects the spinal cord. The spine has three main sections that create natural curves in your back: the neck (cervical), the chest area (thoracic) and the lower back (lumbar). Below the five lumbar vertebrae is the sacrum, made of vertebrae fused together, which joins the spine to the pelvis.

Spinal nerves travel through the spinal canal to carry messages between the brain and the muscles. Nerve roots branch out from the spinal cord through openings in the vertebrae.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Symptoms

How It Feels

What are the Symptoms of Spinal Stenosis?

Heavy, weak, tired legs.
Difficulty walking – for some people, walking more than one or two blocks brings on severe leg pain or weakness (AAOS, n.d.).
Pain, numbness or tingling in the buttocks or legs, sometimes reaching the foot.

The symptoms can usually be relieved by sitting down, stopping walking, or leaning forwards (NIAMS, 2023a). Some people find they can ride an exercise bike, or walk further while leaning on a shopping trolley (AAOS, n.d.).

Treatment

Self-Care & Treatment

How to Treat Spinal Stenosis

Stretching exercises, massage and core strengthening often help manage symptoms (AAOS, n.d.). I can help with hands-on treatment and an exercise programme that fits around your medical team's advice. See the My Approach tab for how I work.

1. Therapy

Physical therapists can provide exercises to improve your balance, build your endurance and strength, and maintain flexibility in the spine (NIAMS, 2023b).

2. Medication

AAOS OrthoInfo lists non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, as a treatment that may relieve stenosis pain, and warns that they must be used carefully because they can cause stomach and kidney problems (AAOS, n.d.). (This medicine information comes from AAOS OrthoInfo, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Surgery: the most common operation is a decompressive laminectomy, which removes bone, bone spurs and ligaments pressing on the nerves, sometimes combined with spinal fusion if the spine is unstable; it is generally considered for people whose quality of life is poor because of pain and weakness, including difficulty walking (AAOS, n.d.; NIAMS, 2023b).

How I can help (see the My Approach tab)

Hands-on treatment for the back, hips and legs

Stretching, strengthening and balance exercises

Help pacing your activities and setting up a walking aid

What are the Long-Term Outcomes of Surgical Treatment for Spinal Stenosis?

For most people the results of surgery are good, and leg pain tends to improve more than back pain. However, surgery does not always relieve symptoms, and symptoms can return (AAOS, n.d.).

How Can Manual Therapy Help Spinal Stenosis?

Osteopathic, physiotherapy and chiropractic treatment will not cure spinal stenosis or widen the narrowed canal, but many people find non-surgical treatments help relieve symptoms (AAOS, n.d.). NICE recommends manual therapy only as part of a treatment package that includes exercise (NICE, 2016). It may help by:

Restoring spinal mobility.

Improving posture.

Massage and gentle mobilisation won't widen the canal either, but I can use them alongside exercise to help ease stiffness and muscle tension.

Tips

An ice pack (or bag of frozen peas) wrapped in a tea towel can help reduce pain and swelling (NHS, 2026).
To help with stability and relieve pain, try using a walker or a walking stick. I can help you choose one and set it up.
A heat pack (or hot water bottle) wrapped in a tea towel can help relieve stiffness or muscle spasms (NHS, 2026).

Treatment

My Approach

Stenosis is usually long-lasting, and your medical team leads your care. Massage won't widen the canal, but I can ease the pain and muscle tension that come with it, keep your spine and hips moving, and help you walk further. After surgery, I need your surgeon's okay before any hands-on treatment.

I assess how your back and hips move, which positions ease or bring on your symptoms, your walking, and the feeling, reflexes and strength in your legs.

Easing Pain and Stiffness

Comfortable positions, often on your side or with hips and knees bent, and warm applications on tight tissue
Massage and trigger point work for the low back, hips and hamstrings
Gentle, low-velocity mobilisation of stiff areas, never quick thrusts
After surgery, once you're cleared, gentle lymphatic drainage for swelling, scar work once healed, and a gradual return to strength

Staying Active

Stretching, core strengthening and balance work, with a home programme
Building up walking or cycling, pacing your day, and setting up a walking aid

Work on the buttock and hip muscles needs your informed consent and a written consent form. If your legs feel numb, I use lighter pressure and only mild warm or cool applications. If weakness or numbness increases, see your family doctor or nurse practitioner; the signs in Signs That Need Urgent Help mean calling 911.

What to Expect

Typical Course

Typical course: Early on, most people come about twice a week for around three weeks, then weekly for about a month, with a reassessment along the way, then less often, fitted around your medical team's plan. Stenosis tends to be long term, so we aim for easier movement and walking further, not a cure.

What I Focus On

Working With Your Medical Team

Pain & Spasm Relief

Gentle Mobilisation

Strength & Balance

Walking & Pacing

Please read

When to See a Doctor First

Signs That Need Urgent Help

Rarely, the nerves at the bottom of the spinal canal become severely compressed. This is called cauda equina syndrome. It is a medical emergency and may need emergency surgery (AAOS, n.d.). Call 911 or go to the emergency room at your nearest hospital if you notice:

Numbness around your private area or bottom
Loss of control of your bladder or bowels
Loss of strength in your legs, or not being able to walk

Sources

References

National Institute of Arthritis and Musculoskeletal and Skin Diseases (2023a) Spinal stenosis. Available at: https://www.niams.nih.gov/health-topics/spinal-stenosis (Accessed: 7 October 2026).
National Institute of Arthritis and Musculoskeletal and Skin Diseases (2023b) Spinal stenosis: diagnosis, treatment, and steps to take. Available at: https://www.niams.nih.gov/health-topics/spinal-stenosis/diagnosis-treatment-and-steps-to-take (Accessed: 7 October 2026).
American Academy of Orthopaedic Surgeons (n.d.) Lumbar spinal stenosis. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/lumbar-spinal-stenosis/ (Accessed: 7 October 2026).
National Institute for Health and Care Excellence (2016, updated 2026) Low back pain and sciatica in over 16s: assessment and management (NG59) – Recommendations. Available at: https://www.nice.org.uk/guidance/ng59/chapter/Recommendations (Accessed: 7 October 2026).
NHS (2026) Back pain. Available at: https://www.nhs.uk/conditions/back-pain/ (Accessed: 8 October 2026).

Massage therapy · Kitchener–WaterlooSpinal Stenosis

What It Is

Possible Causes of Spinal Stenosis?

Spinal Stenosis Anatomy

How It Feels

What are the Symptoms of Spinal Stenosis?

Self-Care & Treatment

How to Treat Spinal Stenosis

1. Therapy

2. Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

What are the Long-Term Outcomes of Surgical Treatment for Spinal Stenosis?

How Can Manual Therapy Help Spinal Stenosis?

Tips

My Approach

Easing Pain and Stiffness

Staying Active

Typical Course

When to See a Doctor First

Signs That Need Urgent Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooSpinal Stenosis

What It Is

Possible Causes of Spinal Stenosis?

Spinal Stenosis Anatomy

How It Feels

What are the Symptoms of Spinal Stenosis?

Self-Care & Treatment

How to Treat Spinal Stenosis

1. Therapy

2. Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

What are the Long-Term Outcomes of Surgical Treatment for Spinal Stenosis?

How Can Manual Therapy Help Spinal Stenosis?

Tips

My Approach

Easing Pain and Stiffness

Staying Active

Typical Course

When to See a Doctor First

Signs That Need Urgent Help

References

Related Conditions

Lumbar Spinal Stenosis

Cervical Spondylotic Myelopathy

Cervical Disc Herniation

Degenerative Disc Disease (DDD)

Book a session