SPINAL STENOSIS Spinal stenosis is narrowing of the spinal canal. This narrowing can squeeze (compress) and irritate the nerve roots that branch out from the spinal cord, or it can squeeze and irritate the spinal cord itself. This can cause pain, numbness, weakness, or cramping sensation most often in the extremities or trunk. These symptoms are usually exacerbated by standing or walking, and alleviated by bending forward and rest. Treatment for progressive symptoms is surgery. Pain management is usually started with pharmacotherapy, and can be followed with injectional modalities such as epidural steroid injections. In patients that experience neuropathic pain with radiation to lower extremity, spinal cord stimulation can be effective. In selected patient that are not surgical candidates and have escalating opioid dose requirements, implantation of a drug delivery system can be considered.