Spinal stenosis diagnosis
Before we examine conservative spinal stenosis treatment, let's look at how spinal stenosis is diagnosed. The typical symptoms of lumbar spinal stenosis include leg pain which is aggravated by walking. This leg pain will be either with or without back pain. A conclusive diagnostic is made when a patient presents these symptoms to their physician. The diagnosis is formed by using imaging studies from an MRI (Magnetic resonance imaging) or a CT (computed tomography) scan with myelogram, which is the process of using an x-ray dye in the spinal sack fluid. A physical examination alone will not be able to provide enough evidence for a conclusive diagnosis.

Accurate identification of the type of spinal stenosis is important for proper treatment. The three major types of spinal stenosis are:

Lateral Stenosis: Once the nerve has exited the spinal canal it can be compressed by either a bone spur, bulging disc, or herniated disc. This is call Lateral stenosis and is the most common form of spinal Stenosis.

Central Stenosis: The cauda equine (horse's tail) is a bundle of loose nerve filaments. When the sack that contains these nerves is compressed it is termed central spinal stenosis. This form of spinal stenosis is most common at the second from the lowest lumbar spinal level and higher. This is most commonly caused by bulging disc or an overgrowth of ligament which is the to help protect the dura. A degenerating disc will often cause this overgrowth.

Foraminal Stenosis: As the nerve root is about to leave the canal through a side hole (lateral foramen), a bone spur (osteophyte) that has already developed from a degenerating disc can press on that nerve root.. 72% of cases of foraminal stenosis occur at the lowest lumbar level, trapping the emerging nerve root (which comprises a major part of the sciatic nerve).
Spinal stenosis treatment

Conservative treatments for spinal stenosis may include:

- Activity modification: Most patients suffering from spinal stenosis will usually feel more comfortable flexed forward. The discomfort of walking can be eased by leaning on a cane, walker or shopping cart.

- Exercise: Although exercise is not considered a cure, a physical therapist with a suitable exercise program can help to prevent any further debilitation that arises from inactivity. For obvious reasons that we have already covered, being seated and flexed forward on a stationary bike can be a good choice of exercise.

- Non-steroidal anti-inflammatory drugs (NSAIDs): A common symptom of spinal stenosis is inflammation. Anti-inflammatory drugs, such as ibuprofen or aspirin, may be helpful in treating spinal stenosis.

- Epidural injections: These injections usually take fifteen to thirty minutes and are given on an out-patient basis. A needle is guided into the epidural space. The epidural steroid solution is slowly injected once the needle is in position. Epidural injections use steroids as an anti-inflammatory agent, and often include a fast-acting local anesthetic for temporary pain relief.