If you’ve started planning your day around where you can sit down — or you’ve noticed your legs feel heavy, numb, or achy after walking a short distance — you may be dealing with lumbar spinal stenosis.
At McNulty Spine in Las Vegas, Patrick S. McNulty, MD, FABSS, FABOS, is our double-board-certified, award-winning spine specialist with 38+ years of experience treating complex spine conditions. He’s known for careful diagnosis, thoughtful, conservative care, and advanced surgical solutions when needed.
Lumbar spinal stenosis means the spaces around your nerve roots in your low back have narrowed, which can irritate or compress nerves. That pressure often creates the classic symptoms: low back discomfort, buttock or leg pain, tingling, weakness, or a “cramping” sensation with walking that improves when you bend forward or sit.
Treatment depends on what’s causing the narrowing. They also may be contributing narrowing in your thoracic or cervical spine.
The first goal is simple: reduce inflammation, calm irritated nerves, and restore movement.
Physical therapy and specific exercises can strengthen the muscles that support your spine, improve flexibility, and help you move with less strain. It’s also one of the best ways to protect your spine long-term — whether you’re trying to avoid surgery or recover well after it.
Over-the-counter anti-inflammatory options are often part of early care, especially during flare-ups. Dr. McNulty also reviews your overall health and medications to make sure your plan is safe and appropriate.
If pain is keeping you from sleeping, walking, or participating in therapy, injections may be used to reduce inflammation and improve function.
At McNulty Spine, our pain management options can help you get adequate relief so that you can participate in therapy.
Epidural steroid injections place anti-inflammatory medication near irritated spinal nerves to reduce swelling and pressure — often helping relieve radiating leg symptoms so you can stay active and participate in rehab.
Depending on what we find, treatment may also include joint-based injections (such as facet injections) or other targeted procedures to pinpoint the pain generator.
If conservative care and injections haven’t provided enough relief — or if nerve compression is significantly limiting your quality of life — it may be time to discuss surgical options.
Dr. McNulty performs minimally invasive approaches that use smaller incisions and specialized tools to relieve nerve pressure while minimizing muscle disruption.
In general, decompression procedures remove or reshape structures that press on nerves. Common techniques include laminectomy, laminotomy, and microdiscectomy, depending on your anatomy and symptoms.
Sometimes stenosis occurs alongside instability (or develops in a way that would create instability if bone alone were removed). In those cases, Dr. McNulty may recommend decompression combined with spinal fusion and instrumentation to stabilize the spine and protect the nerves. There may be a role for TOPS, a motion sparing facet replacement procedure, although most insurance companies are not yet covering this procedure.
Stenosis care works best when it’s personalized and staged — not rushed.
We typically focus on three things:
Dr. McNulty is well-versed in conservative measures, spinal injections, and complex reconstruction, and he also specializes in minimally invasive and robotic surgical options when appropriate.
If any of these are true, don’t “wait it out.”
If you’re dealing with symptoms that sound like spinal stenosis, we can help you understand what’s driving them and what your best options are — from conservative care to advanced minimally invasive solutions.
Call McNulty Spine in Las Vegas, Nevada, at 702-637-2034 or request an appointment online.
