Spinal Stenosis Treatment in Amman

What is lumbar spinal stenosis?

The nerves to the legs run through a canal formed by the vertebrae of the lower back. With age, changes in the discs and small joints of the spine and thickening of the ligaments can narrow this canal and leave the nerves less room. Standing upright and arching the back narrow the space a little more, while sitting and bending forward open it, which is why symptoms change with posture. Narrowing also shows up on the scans of many older people who have no symptoms at all, so the diagnosis is based on your symptoms and examination together with imaging, not on the scan alone.

Common signs

Pain, heaviness, weakness or tingling in the buttocks and legs when standing or walking, in one leg or both
Symptoms that ease when you sit down or bend forward, rather than just by stopping and standing still
Walking more easily when leaning forward, for example on a shopping trolley, or finding cycling easier than walking
A walking distance that gets shorter, with a need to sit down before you can carry on
Low back pain or stiffness may also be present, but the leg symptoms are often the main problem

Common misunderstandings

"It can only get worse until I need an operation": in many people symptoms stay stable for years, and they may come and go
"Walking harms me, so I should rest": staying active usually helps; we find a level of walking or cycling you can manage, with rests when needed, and build it up gradually
"Leg pain on walking always comes from the back": narrowed arteries in the legs can cause similar pain, which often eases when you simply stop and stand still, so we check your circulation and refer you to a doctor if we suspect it

What usually helps?

Guidance suggests starting with a combined plan: education about the condition and how to manage it, advice on staying active, a home exercise programme and manual therapy. The plan usually includes exercises that bend the lower back forward, such as bringing your knees towards your chest while lying down; strengthening of the trunk, hip and leg muscles; balance exercises; and a walking or stationary cycling programme built up gradually, with short rests sitting or leaning forward when needed. Manual therapy, mobilisation of the back and hips and soft-tissue work are used as part of this package, not on their own. Research on non-surgical treatments is still limited, although some studies suggest that combining manual therapy and exercise may improve pain and walking in the short term. Medicines and injections are the doctor’s decision. For some people whose symptoms stay troublesome despite this, a spine surgeon may discuss an operation to take pressure off the nerves, and the decision is shared between you and the surgeon.

How we treat it at Revibe

We listen: what brings on your leg symptoms, how far you can walk or how long you can stand, what eases them, and your health conditions and medicines
We examine back, hip and leg movement, strength, sensation, reflexes and balance, and look for signs of a circulation problem or other causes that need a doctor
We identify what may slow your progress, such as long standing, inactivity, fear of walking, or weak muscles and poor balance
We treat: manual therapy and joint mobilisation for the back and hips, release of muscle knots around the back, buttocks and legs, and exercise therapy with forward-bending, strengthening and balance exercises
We progress with a gradual walking or cycling plan and a home exercise programme, and adjust them as your walking and confidence improve

When do you need urgent medical care?

Numbness around the buttocks, between the thighs or the genitals, new problems passing urine or stool, or weakness in both legs — go to the emergency department or call an ambulance: 911 in Jordan or 122 in Iraq and Kurdistan
Sudden, severe pain in the back or tummy, especially with feeling faint or pale skin, or a leg or foot that suddenly becomes very painful, cold, pale or numb — go to the emergency department straight away or call an ambulance
Leg weakness that is getting worse, or foot drop, where the front of the foot slaps down or catches when you walk — see a doctor the same day
Back pain with fever or feeling generally unwell, a history of cancer, or unexplained weight loss — see a doctor the same day
Severe back pain after a fall or a minor injury, especially with thinning bones (osteoporosis) — see a doctor the same day

In these cases go to the nearest emergency department or a doctor straight away — instead of booking physiotherapy.

FAQ

Do I need an MRI?

Not always at the start. The diagnosis rests mainly on your symptoms and examination, and a doctor usually requests an MRI when the diagnosis is unclear, when there are worrying signs, or when surgery or an injection is being considered. We refer you when the assessment shows a reason to.

Will I need surgery?

Not necessarily. Many people manage with an exercise and activity plan, and symptoms often stay stable. Surgery may be discussed with a spine surgeon when leg symptoms remain troublesome despite good non-surgical care, or sooner if weakness is getting worse, and the decision is shared between you and the surgeon.

Should I keep walking if my legs hurt?

Usually yes, at a level you can manage. We help you plan walks with short rests, sitting or leaning forward when symptoms build up, and then increase the distance gradually. Many people find a stationary bike easier, because the back is bent forward.

How many sessions will I need?

It depends on your condition and how long you have had it; after the first assessment we explain the plan and the expected number of sessions.

More common questions: Disc and sciatica questions — 31 questions