What This Means in Plain Language
You have wear-and-tear changes in your lower back (lumbar spine) that are causing mild narrowing of the spaces where nerves travel, but nothing severe.
Understanding Your Diagnosis
Your spine has several problems related to aging and degeneration:
Multilevel degenerative changes: Multiple levels of your lower back show arthritis-like wear and tear, similar to how joints wear down over time 1
Malalignment: Your vertebrae (spine bones) are not perfectly lined up as they should be, which can contribute to nerve compression 1
Mild spinal canal stenosis at L1-L2: The main tunnel where your spinal cord travels is slightly narrowed at one level, but this is only mild—not severe 2
Multilevel mild neural foraminal stenosis: The small openings on the sides of your spine where individual nerves exit are mildly narrowed at several levels 1
The good news: No severe spinal canal stenosis means you don't have critical narrowing that would require urgent surgery 2
Treatment Approach
Start with Conservative (Non-Surgical) Treatment
All patients with your condition should begin with non-surgical treatment for at least 3-6 months, as rapid deterioration is unlikely and most patients either improve or remain stable with conservative care 3, 1, 2, 4.
Your treatment plan should include:
Physical therapy focusing on flexion exercises: Specific exercises that bend you forward (flexion) help open up the narrowed spaces in your spine 5, 4. This should be formal, supervised physical therapy for at least 6 weeks 3
Pain medications: Anti-inflammatory medications (NSAIDs like ibuprofen) and potentially medications for nerve pain (gabapentin or pregabalin) if you develop leg symptoms 3, 4
Posture education: Learning proper body mechanics to avoid positions that worsen symptoms 5
General conditioning exercises: Maintaining overall fitness and core strength 5
Epidural steroid injections: If conservative measures don't provide adequate relief, targeted injections can reduce inflammation around compressed nerves 2, 4, 6
When Surgery Might Be Considered
Surgery is only recommended if you develop significant symptoms that don't improve after 3-6 months of comprehensive conservative treatment 3, 2.
Surgery would be considered if you develop:
Severe leg pain or weakness that limits your ability to walk or perform daily activities 2
Neurogenic claudication: Leg pain and cramping that occurs with walking and improves with sitting or bending forward 1, 2
Progressive neurological problems: Worsening weakness, numbness, or loss of bladder/bowel control (the latter requires urgent evaluation) 7, 2
For mild stenosis without instability (slippage of vertebrae), decompression surgery alone—without fusion—is the appropriate treatment if surgery becomes necessary 8, 1. Fusion is only added when there is documented instability or spondylolisthesis (vertebral slippage), which your report does not mention 9, 3, 8.
What to Watch For
Seek immediate medical attention if you develop:
- Sudden severe weakness in both legs 7
- Loss of bladder or bowel control 7
- Numbness in the saddle area (groin/buttocks) 7
- Rapidly progressive leg weakness 7
Bottom Line
Your condition is mild and should be managed conservatively first—the majority of patients with your findings either improve or remain stable without surgery 1, 2, 4. Focus on physical therapy with flexion exercises, pain management, and maintaining activity within your tolerance. Surgery is reserved only for those who develop severe, disabling symptoms that don't respond to at least 3-6 months of proper conservative care 3, 2.