Spinal Stenosis and Epidurals: How Targeted Treatment Can Help You Move With Less Pain

Spinal stenosis happens when the spaces inside the spine become narrower. As that narrowing worsens, it can place pressure on the spinal cord or nearby nerves. For some people, this causes lower back pain. For others, the most frustrating symptoms show up in the legs: aching, cramping, numbness, tingling, weakness, or pain that gets worse with standing or walking.

At Palm Beach Pain Institute in Delray Beach, Florida, Marcie A. Merson, MD, evaluates spinal stenosis symptoms and creates personalized treatment plans designed to reduce pain, improve mobility, and help patients maintain independence.

Why spinal stenosis causes leg pain

The spinal canal protects the nerves that travel from your back into your hips, buttocks, legs, and feet. When arthritis, thickened ligaments, disc changes, bone spurs, or other age-related spine changes narrow that space, the nerves can become irritated or compressed.

Lumbar spinal stenosis often causes symptoms that worsen with walking or standing. Many people notice they feel better when sitting down or leaning forward, such as over a shopping cart. That position can briefly open the spinal canal and reduce pressure on the nerves.

Common symptoms of spinal stenosis include:

• Low back pain
• Buttock, hip, or leg pain
• Cramping while walking
• Numbness or tingling in the legs or feet
• Leg weakness
• Trouble standing or walking for long periods

If you experience new loss of bowel or bladder control, severe weakness, or rapidly worsening symptoms, seek urgent medical care.

How spinal stenosis is diagnosed

Because spinal stenosis can feel similar to sciatica, herniated discs, arthritis, or other back conditions, an accurate diagnosis is essential. During your visit, Dr. Merson reviews your symptoms, medical history, activity level, and past treatments.

Your evaluation may include a physical exam, neurological testing, strength and reflex checks, and a review of how your pain changes with movement. Imaging, such as X-rays or MRI, may also be recommended to look for narrowing in the spinal canal, bone spurs, disc problems, or other structural causes.

Once the source of your pain is clear, treatment can be matched to your symptoms instead of relying on guesswork.

Where epidural steroid injections fit in

Epidural steroid injections are commonly used when spinal stenosis causes nerve-related pain, inflammation, or radiating symptoms. During the procedure, anti-inflammatory medication is placed into the epidural space around irritated spinal nerves.

The goal is not to “cure” spinal stenosis or reverse arthritis. Instead, epidurals may reduce inflammation around the nerves, calm pain signals, and make it easier to walk, exercise, participate in physical therapy, and complete daily activities.

Depending on your symptoms and imaging findings, Dr. Merson may recommend different types of epidural injections, including:

Interlaminar epidural injections

This approach delivers medication into the epidural space from the back of the spine. It may be helpful when symptoms affect a broader region.

Transforaminal epidural injections

This is a more targeted approach that places medication near the nerve root as it exits the spine. It may be used when pain follows a specific nerve pathway into the leg.

Caudal epidural injections

This approach enters through the lower end of the spine and may be considered for certain lower back and leg pain patterns, including symptoms after prior spine surgery.

Other treatment options for spinal stenosis

Most patients benefit from a combination of treatments. Epidurals may be part of the plan, but they are often most effective when combined with other strategies that support long-term mobility.

Treatment may include physical therapy, activity changes, medication management, osteopathic manual therapy, anti-inflammatory measures, and targeted strengthening. For some patients, other interventional treatments may be appropriate if pain is coming from joints, discs, or other structures in addition to stenosis.

Surgery is not always necessary. However, if symptoms are severe, progressive, or do not respond to conservative and minimally invasive care, Dr. Merson can help determine whether a surgical consultation is appropriate.

What happens after treatment?

Relief from an epidural injection can vary from person to person. Some patients feel improvement within a few days, while others notice gradual relief over one to two weeks. Follow-up is important because it helps determine whether the injection reduced pain, improved walking tolerance, or made physical therapy more effective.

If symptoms return, your care plan may be adjusted. That may mean repeating an injection when appropriate, changing your therapy plan, reviewing updated imaging, or considering additional treatment options.

Take the next step toward relief

Spinal stenosis can make everyday movement feel harder than it should. But with the right diagnosis and a personalized treatment plan, many patients can reduce pain and stay active.

If back or leg pain is limiting your life, schedule an evaluation at Palm Beach Pain Institute in Delray Beach, Florida. Call 561-499-7020 or book an appointment online today.