Dr. David Kulla, DC provides individualized conservative care for spinal stenosis at Synergy Wellness Chiropractic & Physical Therapy in New York City. With more than 26 years of clinical experience, Dr. Kulla evaluates patients with lower back pain, neck pain, leg symptoms, numbness, tingling, weakness, and mobility limitations that may be associated with spinal stenosis.
Our Manhattan office at 237 First Avenue near East 14th Street offers chiropractic care, rehabilitation, Cox Flexion-Distraction, spinal decompression, physical therapy, and other conservative treatment approaches when clinically appropriate.
What Is Spinal Stenosis?
Spinal stenosis is a narrowing of spaces within the spine that can reduce the room available for the spinal cord or spinal nerve roots. It most commonly affects the lumbar spine in the lower back and the cervical spine in the neck.
The presence of spinal narrowing on an MRI does not always mean a person will have symptoms. Clinical findings, neurological examination, symptom patterns, and functional limitations all help determine whether spinal stenosis is contributing to a patient’s condition.
Lumbar vs. Cervical Spinal Stenosis
Lumbar spinal stenosis affects the lower back and may cause lower back pain, heaviness or aching in the legs, numbness, tingling, weakness, or difficulty walking for longer distances.
Cervical spinal stenosis affects the neck and may produce neck pain, arm symptoms, numbness, tingling, weakness, coordination problems, or changes in balance. When the spinal cord itself is affected, medical evaluation is especially important.
What Causes Spinal Stenosis?
Spinal stenosis often develops gradually as the structures of the spine change over time. Contributing factors may include:
- Degenerative changes in spinal joints
- Loss of disc height
- Bulging or herniated discs
- Bone spurs associated with osteoarthritis
- Thickening of spinal ligaments
- Facet-joint enlargement
- Synovial cysts
- Spondylolisthesis
- Congenitally narrow spinal canals
Several of these changes may occur together, which is why treatment should be based on the individual patient rather than on a single MRI finding.
Common Symptoms of Lumbar Spinal Stenosis
Symptoms of lumbar spinal stenosis can vary considerably. Common complaints may include:
- Lower back pain
- Pain, aching, numbness, or tingling in the buttocks or legs
- Leg heaviness or weakness
- Reduced walking tolerance
- Symptoms that worsen with prolonged standing or walking
- Symptoms that improve with sitting or bending forward
- Sciatica-like leg symptoms
Some patients notice that leaning forward over a shopping cart or walker makes walking more comfortable. This is sometimes called the “shopping cart sign” and is commonly associated with lumbar spinal stenosis.
How Is Spinal Stenosis Evaluated?
Dr. David Kulla, DC evaluates each patient individually to determine whether spinal stenosis is likely to be contributing to their symptoms and whether conservative care may be appropriate.
The evaluation may include a detailed health history, orthopedic and neurological examination, assessment of strength and reflexes, gait and balance testing, movement evaluation, and review of MRI or X-ray images when available.
Imaging findings should always be considered together with the clinical examination. A patient may have significant narrowing on MRI with relatively mild symptoms, while another patient with less dramatic imaging findings may experience substantial functional limitations.
Conservative Treatment for Spinal Stenosis
Many patients with spinal stenosis begin with conservative treatment when there are no signs requiring urgent medical or surgical intervention.
Treatment may include chiropractic mobilization or manipulation, rehabilitation, therapeutic exercise, activity modification, physical therapy, and other conservative approaches depending on the patient’s diagnosis, neurological findings, tolerance, and goals.
The objective is to improve movement and function, reduce mechanical irritation when possible, maintain strength and mobility, and help patients remain active.
Cox Flexion-Distraction for Spinal Stenosis
Cox Flexion-Distraction Technique is a specialized chiropractic method performed on a segmented treatment table. The chiropractor uses controlled flexion and distraction movements directed to specific areas of the spine.
For selected patients with lumbar spinal stenosis, disc-related symptoms, restricted spinal mobility, or accompanying nerve irritation, Dr. Kulla may incorporate Cox Flexion-Distraction into an individualized treatment program.
The amount of movement and force is adjusted according to the patient’s examination findings, diagnosis, comfort, and response to care.
Spinal Decompression and Spinal Stenosis
Spinal decompression uses controlled mechanical forces to gently unload selected regions of the spine. It is different from Cox Flexion-Distraction, which is performed manually by the chiropractor on a specialized table.
Neither approach is appropriate for every patient with stenosis. Dr. Kulla determines whether these treatments may be considered after evaluating the patient’s symptoms, examination findings, imaging, and overall health.
Exercise and Rehabilitation for Spinal Stenosis
Exercise and rehabilitation can be important parts of managing spinal stenosis. Treatment may focus on maintaining lower-extremity strength, improving trunk and hip function, increasing mobility, and helping patients tolerate walking and daily activities more comfortably.
Exercise selection should be individualized. A program that works well for one patient may aggravate another patient depending on the location and severity of stenosis, neurological findings, and other spinal conditions.
When Is Surgery Considered for Spinal Stenosis?
Surgery may be considered when spinal stenosis causes progressive neurological loss, significant weakness, severe functional impairment, spinal-cord involvement, or persistent symptoms that have not responded adequately to appropriate conservative treatment.
The decision to undergo surgery depends on the patient’s symptoms, neurological findings, imaging, overall health, and treatment goals. Our role is not to discourage appropriate surgery, but to help patients understand whether conservative treatment may reasonably be attempted first when clinically appropriate.
When Spinal Stenosis Requires Prompt Medical Evaluation
Seek prompt medical attention for new bowel or bladder dysfunction, numbness in the groin or saddle region, rapidly progressive weakness, major changes in balance or coordination, significant difficulty walking, or symptoms following major trauma.
These findings may indicate significant nerve or spinal-cord involvement and require medical assessment rather than routine conservative treatment.
Schedule a Spinal Stenosis Evaluation in NYC
If you have been diagnosed with spinal stenosis, have an MRI report you would like reviewed, or are experiencing back pain, leg pain, numbness, tingling, weakness, or reduced walking tolerance, Dr. David Kulla, DC can evaluate your condition and help determine appropriate next steps.
Synergy Wellness Chiropractic & Physical Therapy is located at 237 First Avenue near East 14th Street in Manhattan. Call (212) 533-4900 to schedule an appointment.