Management

Management of lumbar spinal stenosis with radicular claudication is presented as a long-term, quality-of-life issue rather than something to “cure.” A key theme is careful patient communication: avoid alarming terms such as “trapped nerve” or “ruined back,” and instead explain symptoms in a reassuring way that supports activity and confidence. The main management approach emphasizes shared decision-making, self-management, and appropriate referral rather than trying to do everything within physiotherapy alone. Learners are guided through practical advice: walking is generally safe if tolerated, flexion-based movements can ease symptoms, and regular exercise is encouraged. Cycling is highlighted as a particularly useful option, with emerging evidence showing benefits for leg pain and especially walking distance. Multimodal rehabilitation may also include mobility work, strengthening, and graded exposure to extension where appropriate. Surgery, particularly laminectomy, is covered as an elective option for selected patients, not a routine solution. The evidence for decompression is described as uncertain, with no clear superiority over conservative care in existing studies. The summary also outlines when MRI, specialist referral, and urgent escalation are needed, including warning signs of cauda equina syndrome.