Spinal Stenosis and Conservative Treatment: Chiropractic and Other Treatments Help Protect Mobility and Independence

Back pain can creep up slowly. At first, it’s just a twinge when you bend over or a stiff feeling after sitting too long. But if you’re over 45, those aches may signal something more serious—like spinal stenosis. This narrowing of the spinal canal can turn simple activities you take for granted—such as walking to the mailbox, standing at the kitchen counter, or getting out of the car—into painful or exhausting tasks.

As spinal stenosis progresses, it doesn’t just hurt. It can limit your independence, affect your mood, and increase your risk of falls and injury. You may start avoiding favorite activities, exercising less, and relying more on family members for help.

Lumbar stenosis is seen in approximately 20 to 25 percent of the population … the average age of presentation is 65 years old. — Dr. Daniel Cataldo, DO, orthopedic spine surgeon at Lehigh Valley Orthopedic Institute.

Over time, that loss of mobility can cascade into needing outside caregivers at home or even moving into an assisted living or nursing home setting.

Here’s the hard truth: Medicare and most health insurance plans do not pay for long-term custodial care in the U.S. Outside of short-term skilled rehab stays, you’re largely on your own financially. In Canada and the U.K., coverage varies but still usually involves co-payments or means testing. Without planning, the costs can drain retirement savings quickly.

The good news? Acting early can help you stay in control. Conservative treatments such as chiropractic care, physical therapy, medication management, and lifestyle changes can delay or even prevent surgery—keeping you mobile and independent longer.

In physical therapy, we work on improving mobility and strengthening the core (to support the back). We also work on flexibility, balance and gait, typically twice a week for six weeks, in combination with medication. — Dr. Amber Hennenhoefer, a specialist in physical medicine and rehabilitation at HonorHealth.

Thinking about these medical issues and aging isn’t about fear—it’s about freedom. By understanding spinal stenosis and your treatment options, you’re taking steps to safeguard your quality of life and independence.

What is Spinal Stenosis?

More than 200,000 Americans are diagnosed with spinal stenosis each year, and more worldwide. Spinal stenosis is a progressive narrowing of the spaces within your spine. This narrowing can put pressure on the spinal cord or the nerves that travel through the spine, creating pain, weakness, or numbness that affects everyday life. Most cases develop gradually as part of the aging process.

Spinal stenosis is a fairly common condition where the space for nerves in the spinal canal becomes narrow … causing symptoms affecting the back and the legs, —  Dr. Charles Edwards II, Director, The Maryland Spine Center at Mercy Medical Center and Hospital in Baltimore, Maryland.

You’ll typically see spinal stenosis in two areas:

• Lumbar stenosis (lower back): The most common form, causing pain, tingling, or weakness in the lower back, buttocks, or legs.
• Cervical stenosis (neck): Less common but potentially more serious, as pressure on the spinal cord can affect your arms, balance, or bladder control.

Why does it develop?

• Age-related arthritis leading to thickened ligaments and bone spurs.
• Disc degeneration or bulging discs compressing nerve roots.
• Past spinal injuries, congenital spinal narrowing, or scoliosis.

Early Symptoms You Shouldn’t Ignore

In its early stages, spinal stenosis can be subtle. You may notice:

• Achy or stiff lower back after standing or walking.
• Numbness, tingling, or a “pins and needles” feeling in the legs or feet.
• Leg cramps or heaviness, especially after walking short distances (called neurogenic claudication).
• A tendency to lean forward when walking or sitting down for relief (“shopping cart sign”).
• Trouble with fine motor skills in your hands or clumsiness if the neck area is involved.

These early red flags often appear in your 50s or 60s, but can start sooner, especially if you’ve done heavy physical work or have a family history of spine problems. Catching them early can prevent rapid progression.

How It’s Diagnosed

Your path to diagnosis typically begins with your primary care doctor or a specialist in spine care.

They’ll start with:

• Detailed health history: Discussing symptoms, daily activity limitations, past injuries, and any changes in walking tolerance or balance.
• Physical exam: Testing muscle strength, reflexes, sensation, and gait. Providers often check for pain relief when you lean forward—a hallmark of lumbar stenosis.
• Imaging:

• MRI scans to visualize the spinal canal, discs, and nerves.

• CT scans or CT myelography (with contrast dye) for people who can’t have MRIs.

• X-rays to see spinal alignment, arthritis, or bone spurs.

• Functional tests: Measuring how far you can walk or stand before pain develops and whether posture changes relieve your symptoms.

Early diagnosis matters because conservative treatments—like chiropractic care, physical therapy, and lifestyle changes—are most effective before severe nerve compression sets in. Once symptoms progress to weakness, bowel or bladder changes, or major instability, surgery may become the only option.

Impact as You Get Older

The pain and mobility loss from spinal stenosis can lead to:

• Reduced activity, muscle weakness, and falls.
• Greater dependence on family or paid caregivers.
• Higher risk of depression and social isolation.

If the condition worsens, you may need help with activities of daily living (ADLs)—a key trigger for long-term care services that standard health insurance and Medicare in the U.S. generally do not cover beyond 100 days of skilled care.

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Available Treatments Beyond Surgery

Traditional care includes:

• Physical therapy to improve posture, strength, and balance.
• Medication such as anti-inflammatories or epidural steroid injections for pain control.
• Lifestyle modifications, including weight management, low-impact exercise, and ergonomics.
• Chiropractic care for non-invasive spinal adjustments and decompression techniques.
• Surgery (laminectomy or spinal fusion) when conservative care fails.

Surgery carries higher complication risks for older adults—making conservative management increasingly attractive and widely recommended as a first-line approach.

Chiropractic Care as Part of Conservative Treatment

Chiropractic treatment is a key non-invasive, drug-free option within the broader spectrum of conservative treatments. Chiropractors tailor care for older adults, especially those with osteoporosis or arthritis.

Common techniques include:

• Spinal adjustments to improve joint motion and reduce nerve pressure.
• Flexion-distraction therapy uses a special table to stretch and decompress the spine gently.
• Soft tissue therapy and exercise to stabilize the spine and improve mobility.
• Lifestyle counseling on ergonomics, footwear, and gentle exercise like swimming or walking.

Spinal manipulative therapy and other conservative treatments for low back pain … may play a role as part of a multimodal approach to lumbar spinal stenosis. — Canadian Chiropractic Guideline Initiative.

Evidence suggests that chiropractic care is potentially beneficial when combined with other conservative treatments.

Growth in Use of Conservative Treatment

The National Center for Complementary and Integrative Health reports chiropractic care is one of the most frequently used complementary health approaches in the U.S., but it’s part of a broader trend toward multimodal care.

Physical therapy, acupuncture, and structured exercise programs are also growing in popularity as older adults look for non-surgical ways to manage chronic back pain. In the U.S., 11 percent of adults reported using chiropractic care in 2022, up from 9.1 percent in 2012.

How Conservative Treatment Differs by Country

• United States: Chiropractors are licensed at the state level. Medicare Part B covers manual manipulation of the spine to correct a vertebral subluxation when medically necessary, but it generally does not cover other chiropractic services (X-rays, exams, massage). Private insurance policies vary.
• Canada: Coverage varies by province. For example, British Columbia covers chiropractic only for patients with supplementary benefits, Ontario’s OHIP does not cover chiropractic, and Alberta’s Coverage for Seniors plan provides $25 per visit up to $200/year. Many Canadians rely on supplemental insurance or out-of-pocket payment.
• United Kingdom: Chiropractic services are not widely available on the NHS, and access depends on local availability; many people self-pay or use private insurance. The General Chiropractic Council statutorily regulates chiropractors.

Across all three countries, older adults typically pay at least some out-of-pocket costs. Verify your coverage before starting any treatment plan.

Connection To Long-Term Care Needs

If spinal stenosis progresses, you may need help with walking, bathing, or dressing—qualifying you for long-term care services. In the U.S., Medicare and regular health insurance do not cover ongoing custodial care. Long-Term Care Insurance will pay for all types of long-term care services and is usually purchased before retirement, often in your 50s.

Learn More: LTC News Long-Term Care Insurance Education Center

• Canada: Long-term care services vary by province and often require co-payments. Private Long-Term Care Insurance is available and is usually purchased before retirement.
• U.K.: Social care funding depends on means testing, with many older adults paying part or all of their residential care costs.

Planning with Long-Term Care Insurance or other funding options can protect your savings and give you more choice over where and how you receive extended care when needed.

Find a qualified Long-Term Care Insurance specialist to get accurate LTC Insurance quotes from all the top-rated insurance companies that offer long-term care solutions.

Protecting Your Independence

You can take proactive steps:

• Address symptoms early.
• Stay active with low-impact exercise.
• Work with a chiropractor or physical therapist who is experienced in treating older adults.
• Plan financially for possible long-term care needs.

Ask yourself: If spinal stenosis made walking difficult, how would you afford quality care? Your answer today can shape your options tomorrow.

Key Takeaways

• Spinal stenosis is common and potentially disabling for adults over 50.
• Conservative treatment—including chiropractic, physical therapy, and lifestyle changes—offers a non-drug, non-surgical path to pain relief and functional recovery.
• Coverage varies widely between the U.S., Canada, and the U.K.; always check your insurance and budget for potential out-of-pocket costs.
• Long-term care planning is essential; health insurance and Medicare do not cover ongoing custodial care in the U.S.

Always consult a qualified health professional before starting or changing any treatment plan.