Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back that squeezes the nerves inside it. It typically causes pain, cramping, numbness or weakness in the legs when you stand or walk, and the symptoms ease when you sit or bend forward. At Loop Medical Center, Dr. Nidal Elbaridi treats spinal stenosis with physical therapy, movement and strengthening, epidural steroid injections and, when these aren’t enough, two minimally invasive procedures: MILD and Vertiflex.
Dr. Elbaridi performs the full spectrum of interventional pain management, from diagnostic nerve blocks and radiofrequency ablation to minimally invasive spine procedures and implanted devices. Every plan is interdisciplinary: physical therapy, movement and strengthening, coordinated with your primary care doctor and, when needed, a spine surgeon.
What is lumbar spinal stenosis?
Spinal stenosis is a narrowing of the spinal canal that creates pressure on the spinal cord or nerve roots. It is most common in the lumbar spine (the lower back) and develops gradually as a result of age-related changes, including arthritis, bone spurs, thickened ligaments and disc degeneration. It can also follow an injury.
Spinal stenosis is not the same as a herniated disc. A herniated or bulging disc presses on a single nerve root and is treated differently; see disc decompression. The two conditions can occur together, which is one reason Dr. Elbaridi reviews your imaging himself before recommending any treatment.
Symptoms of spinal stenosis
- Pain, cramping or heaviness in the buttocks and legs when standing or walking
- Relief when sitting down or bending forward, for example leaning on a shopping cart
- Numbness or tingling in the legs or feet
- Weakness in the legs
- Lower back pain
Stenosis in the neck (cervical stenosis) can press on the spinal cord itself. Hand clumsiness, difficulty walking or weakness in the arms or legs can be signs of cervical myelopathy, which needs an urgent surgical referral. Dr. Elbaridi refers these patients to a spine surgeon right away.
How Dr. Elbaridi diagnoses spinal stenosis
Your first visit is a consultation and evaluation, not a procedure. Dr. Elbaridi takes a detailed history of your symptoms, examines how you stand, walk and move, and checks strength, sensation and reflexes in your legs. He reviews any MRI, CT scan or X-ray you bring, and orders imaging if you don’t have recent studies. When it’s unclear whether leg symptoms come from the spine or from a nerve elsewhere, EMG and nerve conduction studies can help tell the difference.
Treatment options
Physical therapy, movement and strengthening
Movement, physical therapy and strengthening are the core of recovery. Procedures are a bridge that makes that work possible: when pain eases, you can walk farther and do more of the exercises that keep your back strong.
Epidural steroid injections
An epidural steroid injection places anti-inflammatory medicine in the space around the compressed nerves, which can reduce swelling and leg pain. Read more about injections and nerve blocks.
Minimally Invasive Lumbar Decompression (MILD)
During a MILD procedure, small pieces of excess bone and thickened ligament are removed through a small opening in the back, providing more space within the spinal canal. In doing so, pressure on the nerves is reduced, which can reduce pain and increase mobility. MILD is an outpatient procedure, and it has been shown to increase the amount of time that patients with lumbar spinal stenosis can walk and remain standing.
Vertiflex (interspinous spacer)
During a Vertiflex procedure, a small device is placed between two spinous processes, the thin bony projections on the back of the spine. It holds the space open, which creates more room in the spinal canal and relieves pressure on the nerves when you stand and walk. Unlike MILD, no bone or ligament is removed, which means less trauma to muscles and other structures.
Every procedure is performed under fluoroscopy or ultrasound guidance.
When surgery is the right option
Some patients need surgery, for example when stenosis is severe or symptoms keep getting worse despite treatment. If surgery is the right option, Dr. Elbaridi will tell you and refer you to a spine surgeon, and he keeps your primary care doctor informed.
Frequently Asked Questions
Who is a candidate for MILD or Vertiflex?
Patients with lumbar spinal stenosis whose leg symptoms limit how long they can stand or walk, and who haven’t improved enough with physical therapy and injections. Dr. Elbaridi decides which procedure, if any, fits after examining you and reviewing your imaging.
What is the difference between MILD and Vertiflex?
Both create more space for the nerves in the lower back. MILD removes small pieces of excess bone and thickened ligament. Vertiflex places a small spacer between two spinous processes and removes nothing.
Do I need imaging before my first visit?
No. Bring any MRI, CT scan or X-ray you already have. If you don’t have recent imaging, Dr. Elbaridi will order what is needed before recommending any procedure.
Is spinal stenosis treatment covered by insurance?
Most insurance accepted, including Medicare, Medicare Advantage, PPO and HMO plans. Coverage depends on medical necessity — we verify before your visit. We verify benefits and pre-authorize before your procedure, so there are no surprise bills afterward.
Where to see Dr. Elbaridi
Dr. Elbaridi sees spinal stenosis patients at our South Loop office (1921 S Michigan Ave, Monday to Friday) and our Streeterville office (432 E Grand Ave, Ste A, Thursday and Friday). Same-week appointments are available. Meet Dr. Elbaridi, or read about our spine care in Chicago.
Insurance and billing
Most insurance accepted, including Medicare, Medicare Advantage, PPO and HMO plans. Coverage depends on medical necessity — we verify before your visit. We verify benefits and pre-authorize before your procedure, so there are no surprise bills afterward.