Spinal stenosis is a narrowing of the spinal canal or the openings where nerves exit, putting pressure on the spinal cord or nerve roots. The hallmark of lumbar stenosis is leg pain or heaviness when walking or standing that eases with sitting or leaning forward. Most patients are managed without surgery: at Dr. Imran Qureshi’s Katy, TX office, treatment typically combines epidural steroid injections delivered under X-ray guidance with flexion-based physical therapy — expanding how far you can walk comfortably and protecting your independence.
Understanding Spinal Stenosis
Spinal stenosis develops when the spaces within the spine narrow, creating pressure on the spinal cord and nerve roots. It is overwhelmingly a condition of wear over time: degenerative spinal changes affect up to 95% of people by age 50, and lumbar stenosis is the most common reason adults over 65 undergo spine surgery. It most often affects the lumbar spine (lower back), producing the classic pattern of leg symptoms with walking, and less commonly the cervical spine (neck), where it can affect the arms and balance.
Not all narrowing causes symptoms — imaging frequently shows stenosis in people who feel fine. That is why Dr. Qureshi treats the patient, not the MRI: the goal of evaluation is to confirm that the narrowing seen on imaging is actually responsible for your symptoms before any treatment is recommended.
Most spinal stenosis is managed without an operation. Injections, targeted physical therapy, and activity strategy control symptoms for the majority of patients. Dr. Qureshi’s role is to maximize your walking distance and quality of life non-surgically — and to recognize promptly when a surgical opinion is genuinely warranted.
What causes spinal stenosis?
Stenosis is usually the cumulative result of several age-related changes narrowing the same space:
- Facet joint osteoarthritis and bone spurs — enlarged, arthritic joints and bony overgrowth that crowd the spinal canal
- Thickened spinal ligaments — the ligamentum flavum stiffens and buckles inward with age, narrowing the canal from behind
- Bulging or herniated discs — disc material encroaching on the canal or nerve-exit openings from the front
- Degenerative disc disease — loss of disc height that shrinks the openings (foramina) where nerve roots exit
- Spondylolisthesis — forward slippage of one vertebra that kinks the canal
- Congenital narrowing — a minority of patients are born with a narrower canal and develop symptoms earlier in life
What are the symptoms of spinal stenosis?
- Leg pain, heaviness, cramping, or fatigue brought on by walking or prolonged standing (neurogenic claudication)
- Relief with sitting or leaning forward — many patients comfortably push a shopping cart or ride a bike, but struggle to walk upright
- A steadily shrinking comfortable walking distance
- Numbness or tingling in the legs or feet
- Low back pain, often milder than the leg symptoms
- In cervical stenosis: arm numbness or clumsiness, and balance difficulty
When to See a Pain Specialist
See Dr. Qureshi if leg symptoms are limiting how far you can walk, if you're arranging your life around sitting breaks, or if numbness and tingling are progressing. Seek immediate evaluation for rapidly worsening leg weakness, frequent falls, or new bladder or bowel changes. If your leg pain is sharp and radiating rather than activity-dependent, it may be sciatica from a compressed nerve root — a related but distinct problem with its own treatment pathway.
How is spinal stenosis diagnosed?
Diagnosis combines your symptom pattern — the walking-related leg symptoms and flexion relief are highly characteristic — with a physical examination and MRI, which shows exactly where and how severely the canal is narrowed. Dr. Qureshi reviews your imaging himself and correlates each finding with your symptoms. When several levels look narrowed on MRI, a diagnostic injection can pinpoint which level is actually generating symptoms, so treatment is aimed precisely.
What non-surgical treatments help spinal stenosis?
Treatment is matched to the location and severity of the narrowing:
- Lumbar epidural steroid injections — anti-inflammatory medication delivered under X-ray guidance into the narrowed canal to calm compressed, inflamed nerves; the cornerstone interventional treatment for stenosis leg pain
- Flexion-based physical therapy — strengthening and posture programs that maximize the canal space you have and extend pain-free walking distance
- Facet joint injections and radiofrequency ablation — when arthritic facet joints contribute a significant share of the back pain
- Activity strategy — structured guidance on pacing, posture, and aids (like an inclined treadmill or bike) that keep you active without flaring symptoms
- Anti-inflammatory and neuropathic medications — short-term symptom support; Dr. Qureshi's practice is opioid-free
- Spinal cord stimulation — an option for selected patients with persistent nerve pain who are not surgical candidates
Weighing your options against an operation? Learn more about back pain surgery vs. injection therapy.
Why Choose Dr. Qureshi for Spinal Stenosis
Dr. Qureshi is fellowship-trained in interventional spine and musculoskeletal medicine with board certification in Physical Medicine and Rehabilitation. He has helped thousands of Greater Houston patients stay mobile and independent, performs every spinal injection himself under fluoroscopic guidance, and follows an opioid-free philosophy focused on function: the measure of success is how far you can walk, not just a pain score.