Spinal stenosis refers to a narrowing in the spine at either the spinal canal or the openings on the side, the foramen. With spinal stenosis, you either have canal stenosis or foraminal stenosis. The narrowing itself is a structural problem and treatment is aimed at and reducing how much pressure is being put on the spinal segment. Chiropractic care cannot reduce the narrowing itself, but symptoms can be relieved or reduced.
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Why does leaning forward make stenosis feel better?
Your body will tell you what it needs and what’s happening with how your body and posture respond. “It feels better when I do this” and “it feels worse when I do this” are very helpful pieces of information to share with your doctor. Bending forward (flexion) opens up the space that is being narrowed and standing upright or leaning back (extension) closes the space. This is why patients will share that leaning on a shopping cart or riding a bike are activities they can still do and even that they take the pressure off.
What do we measure before treating stenosis?
Even if you already have an MRI or CT scan showing spinal stenosis, we will still take our own x-rays prior to doing any treatment. We cannot see canal stenosis on x-ray, but we can see how your spine is stacked and the level of degeneration present. Our lower back x-rays include both the lumbar spine and the pelvis. It makes sense to evaluate the foundation your lumbar spine is sitting on as a part of the process.
Once we have the x-rays, we measure the lumbar curve, the femur heights, the pelvis, the sacrum, and each lumbar segment’s tilt and rotation. We then put that into a document that the doctor can pull up every time you are in the office for treatment to make sure we are adjusting what needs to be adjusted and in which direction.
What does care actually change?
Your spine is designed to move and for patients dealing with spinal stenosis, it isn’t moving. By doing our initial evaluation and then doing specific chiropractic adjustments, the right segments start to move again. I think it like a rusty joint that’s been stuck in one spot for a long time. The first couple of adjustments, we get a little movement. Then, little by little, you can feel that the spine moving more and more easily each time. That restored movement results in better range of motion, reduced stiffness, better mobility, and less pain.
Next, and almost as important, we utilize non-surgical spinal decompression therapy to gently pull the spinal segments apart, giving more space to the spine, discs, and nerves. The discs act as spacers between spinal segments and opening up that space gives patients suffering with foraminal stenosis room for their nerves to work and function again. The spinal decompression machine we use, also has the ability to pull from side to side, further opening up the space between spinal segments.
What patients notice is less pain and stiffness and then easier walking when they are leaving the office. Initially, the relief is short-lived (maybe hours to days) but after a few weeks, the pressure is taken off more consistently and the relief lasts longer.
How do you know if it is stenosis and not something else?
What changes the leg symptoms is usually the best clue. Symptoms that build the longer you stand or walk, then ease when you sit or lean on a shopping cart, tend to point us towards a diagnosis of stenosis. A disc often does the opposite and gets worse with sitting. Patterns overlap, so we sort it out with an exam and a standing x-ray.
Frequently asked questions
Can spinal stenosis get better without surgery? The narrowing itself doesn’t reverse. What usually changes is the pain and what people can do. According to PubMed, one study followed 146 people with moderate symptoms who weren’t sent to surgery for about three years (Wessberg 2017). Leg pain improved in 32%, held steady in 55%, and got worse in 13%. A systematic review also found moderate-quality evidence that a non-surgical approach combining manual therapy and exercise works (Ammendolia 2022).
Is walking good or bad for spinal stenosis? Walking is usually worth doing and how you walk matters. Standing upright closes the space, and a slight forward lean opens it, which is why pushing a shopping cart feels easier. In that same 2017 group, pain eased on its own for some people but walking ability didn’t. Walking tolerance is the part that needs deliberate work.
Does stenosis always get worse over time? No. A 2025 study followed 202 people for about 10 years on average (Ng 2025). About 1 in 5 had a meaningful decline, most often a shorter walking tolerance, and most stayed on their feet. That study only looked back at existing records. A spine committee review also found that how narrow the canal looks on a scan doesn’t line up well with how someone feels (Zileli 2020).