What to expect from physiotherapy for spinal stenosis

Spinal stenosis is narrowing around the spinal nerves. Symptoms may include back or leg pain, tingling, heaviness or weakness that changes with standing and walking. Your therapist will consider the level of the spine involved, your walking pattern, leg strength, balance and the positions that make symptoms settle.

Sessions may use comfortable spinal movement, abdominal and hip strengthening, balance practice and advice on posture or supported walking. Some people tolerate a slightly forward-leaning position better, while others need a different approach. The plan is based on function rather than a single exercise for everyone.

Use the positions and rest breaks agreed with your therapist, and change tasks before leg symptoms become intense. Several shorter walks may be more manageable than one continuous walk. Practise strength and balance exercises near stable support, especially if a leg feels weak.

Report whether symptoms return to their usual level after activity or continue spreading, weakening or lasting longer. Avoid pushing through increasing nerve symptoms. A walking aid or altered route may help while endurance is rebuilt, if recommended.

Seek urgent medical care for new loss of bladder or bowel control, numbness around the inner thighs or genitals, or rapidly worsening weakness in one or both legs. These symptoms can signal serious nerve compression.

Arrange review when walking ability declines quickly, pain becomes severe at rest, or the programme repeatedly increases numbness or weakness. A clinician may need to reassess the spine and discuss further treatment.

Ask which positions are likely to ease your symptoms, how to measure walking progress, when a walking aid is useful, and which nerve changes should prompt urgent contact.