Spinal stenosis happens when the spaces in your spine narrow and put pressure on the spinal cord or nerves. This can lead to back or neck pain, leg or arm symptoms, and difficulty walking or standing for long periods.
At the University of Miami Health System, orthopedic spine specialists focus on spinal stenosis treatment that helps you stay active and independent. Our orthopedic specialists start with conservative, non-surgical treatment options and recommend surgery only if your symptoms persist and keep you from doing daily activities.
UHealth orthopedic surgeons prioritize preserving your mobility and function to give you the quickest recovery and best possible long-term outcomes. We offer motion-preserving surgical options, such as minimally invasive decompression and motion-preserving laminoplasty. Fusion surgery is recommended only when less invasive approaches are unable to provide symptom relief.
Understanding spinal stenosis
Spinal stenosis is a narrowing of the spaces in the spine that can put pressure on the spinal cord or the nerves that branch out to your arms and legs. It most often affects the neck (cervical spine) and lower back (lumbar spine). Over time, age-related changes in the bones, joints, and ligaments of your spine can contribute to this narrowing, especially if you have arthritis or other degenerative spine conditions.
Causes and risk factors of spinal stenosis
Common causes and contributing factors include:
- age-related wear and tear on the spine
- osteoarthritis and bone spurs
- thickened ligaments in the spine
- herniated or bulging discs
- conditions like spondylolisthesis (one vertebra slipping over another)
- past spine injuries or surgery
Your UHealth orthopedic specialist will look at the whole picture — imaging scans, physical exam findings, and your medical history — to understand why your spinal canal has narrowed.
Symptoms of spinal stenosis
Some people with spinal stenosis have no symptoms. For others, the condition can be painful and limit mobility and coordination. Your symptoms depend on where the narrowing occurs and which nerves are affected.
Common symptoms include:
- low back pain that may come and go
- leg pain, numbness, tingling, or weakness, especially when walking or standing
- a feeling of heaviness or fatigue in the legs that improves when you sit or bend forward (often called neurogenic claudication)
- neck pain, arm pain, or hand weakness with cervical spinal stenosis
- problems with balance or coordination
Complications of spinal stenosis
Seek immediate emergency care right away if you experience:
- sudden difficulty controlling your bladder or bowels
- severe or quickly worsening leg weakness
- numbness in the area around the groin
These symptoms can be signs of serious nerve or spinal cord compression that requires urgent evaluation and care.
When should I see an orthopedic doctor for spinal stenosis?
Make an appointment with a UHealth orthopedic spine specialist if you have:
- back or neck pain that lasts more than a few weeks
- leg or arm pain, numbness, or weakness when you walk or stand
- symptoms that interfere with work, sleep, or daily activities
- spine pain after a fall, accident, or injury
Your UHealth orthopedic specialist can confirm whether spinal stenosis is the source of your pain and help you understand your treatment choices.
How do our orthopedic specialists diagnose spinal stenosis?
UHealth’s orthopedic spine doctors can diagnose spinal stenosis after considering your:
- Medical history – when your symptoms started, what makes them better or worse, any prior injuries or surgeries
- Physical and neurologic exam – checking your posture, range of motion, reflexes, strength, and sensation
- Imaging tests – X-rays to look at your bones and disc spaces; MRI scans to evaluate your discs, nerves, and soft tissues more closely; and CT scans when more detailed bone images are needed
- Additional tests (when needed) – nerve conduction tests or electromyography (EMG) can help evaluate your nerve function
Orthopedic treatment options for spinal stenosis
There is no single “best” treatment for spinal stenosis. The right plan depends on:
- where the narrowing is located
- how severe your symptoms are
- how long you have had symptoms
- your age, overall health, and activity level
- how you respond to non-surgical care
Non-surgical treatment options for spinal stenosis
Your UHealth orthopedic team will always prioritize the following non-surgical treatment options for spinal stenosis, whenever appropriate. These treatments often reduce pain, improve walking tolerance, and delay or avoid the need for surgery.
Pain management
Depending on your health history and level of pain, your doctor may recommend:
- over-the-counter medicines such as anti-inflammatory drugs like ibuprofen and/or pain killers like acetaminophen
- anti-inflammatory creams/ointments
- prescription medications to reduce pain and inflammation, used for a limited time when needed
Physical therapy and exercise
A UHealth physical therapist can design a program to support your spine and improve how you move. Before starting your new exercise program, tell your therapist if you have significant leg weakness, balance problems, or other medical conditions.
Your physical therapy plan may include:
- forward-bending stretches and other flexion-based exercises
- core strengthening (for example, gentle bridges or supported planks)
- low-impact aerobic activity, such as walking, cycling, or swimming
Your UHealth physical therapist can help you:
- improve strength in your core, hips, and legs to support your spine
- work with you on posture and body mechanics for walking, standing, and lifting
- build a home exercise program to help you manage symptoms long term
Click here to learn more about UHealth’s physical therapy services.
If your treatment plan includes surgery, physical therapy remains essential to your return to daily activities and long-term recovery.
Interventional treatments
If your symptoms of spinal stenosis persist following medications and physical therapy, your UHealth orthopedic specialist may recommend one or more of the following interventional treatments prior to considering surgery. Your orthopedist will review the benefits and risks of each option and monitor how well interventional treatment is working for you.
UHealth can administer the following non-surgical, interventional treatments for spinal stenosis:
- epidural steroid injections
- other image-guided injections
These treatments place anti-inflammatory medicine near the irritated nerves to help reduce swelling and pain, often making it easier to participate in physical therapy and daily activities.
Surgical treatments for spinal stenosis
Surgery is not the first step for most patients with spinal stenosis. Your UHealth orthopedic specialist will consider surgery only if:
- your symptoms of spinal stenosis do not improve with non-surgical care
- you continue to experience significant leg weakness or difficulty walking
- your scans show signs of spinal cord or nerve root damage
UHealth’s orthopedic department focuses on minimally invasive surgical techniques that involve minimal muscle and tissue dissection. Our approach helps preserve your tissue and promote your postoperative recovery. If you are not a candidate for motion-preserving surgery, your UHealth doctor may consider a fusion or decompression procedure to relieve your symptoms. This conservative approach ensures that we move forward with surgery with a high level of confidence that it will improve your symptoms.
UHealth’s orthopedic spine surgeons specialize in the following procedures to treat spinal stenosis:
- Minimally Invasive Decompression
- Extreme Lateral Surgery
- Motion-Preserving Laminoplasty
- Discectomy/Microdiscectomy
- Cervical Disc Replacement
- Lumbar Disc Replacement
- Fusion
UHealth orthopedic spine surgeons may discuss several surgical options, depending on your anatomy and goals. When appropriate, they partner with UHealth’s neurosurgeons for complex or highly specialized procedures.
Recovery and rehabilitation after treatment
We place a strong emphasis on optimizing your postoperative outcomes. UHealth’s orthopedic specialists routinely collect patient-reported outcome data, allowing us to objectively measure the success of spine surgeries, refine our approaches, and contribute to research through published studies.
Pain management during recovery
Pain control often includes a combination of strategies, such as:
- short-term use of medications recommended by your doctor
- physical therapy
- ice or heat to manage soreness
- gentle stretching and gradual activity
- relaxation and breathing techniques to ease muscle tension
Long-term management and returning to activities
By following our pre- and post-operative recommendations and care plan, UHealth patients are typically able to return to their regular activities over time. Your long-term management plan may include:
- staying active with low-impact exercises
- keeping up with your home exercise routine
- maintaining a healthy weight
- avoiding tobacco use
- using good posture and safe lifting techniques at work and at home
Multidisciplinary, research-backed care for better outcomes
UHealth is part of a robust academic health system, which places us at the forefront of research on conditions including spinal stenosis. Our doctors and surgeons conduct extensive, multidisciplinary research focused on identifying risk factors for spinal stenosis and improving spinal surgery techniques and patient outcomes.
When UHealth patients with spinal stenosis are referred to physical therapy, our orthopedic specialists coordinate care with our physical therapists to ensure patients receive personalized and targeted therapies for optimal results.
When spinal injections are recommended for UHealth patients with spinal stenosis, our orthopedic specialists communicate closely with our interventional treatment providers in a coordinated effort to relieve symptoms without surgery.
Questions to ask your UHealth orthopedic specialist
Bringing a list of questions to your visit can help you make decisions with confidence. You may want to ask:
- What is causing my back or neck pain?
- Which non-surgical treatments do you recommend first?
- How long should I try non-surgical treatment before considering surgery?
- What are the potential benefits and risks of surgery in my case?
- What exercises are safe for me to do at home?
- How will we track my progress over time?
Why choose UHealth for spinal stenosis orthopedic treatment?
At UHealth – University of Miami Health System, spinal stenosis care is a team effort.
We emphasize:
- Conservative care first. Non-surgical treatment for spinal stenosis is the starting point for most patients.
- Shared decision-making. Your doctor explains all appropriate options and helps you weigh pros and cons based on your goals.
- Collaboration across disciplines. When you need advanced or minimally invasive spine surgery, UHealth’s orthopedic specialists coordinate closely with our neurosurgeons.
- Coordinated care. We connect you with UHealth’s related services, such as physical therapy and interventional therapies, in one integrated health system.
FAQs about spinal stenosis orthopedic treatment at UHealth
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