How is lumbar spinal stenosis diagnosed?

Lumbar spinal stenosis can usually be diagnosed based on your history of symptoms, a physical exam, and imaging tests—tests that produce various kinds of pictures of your body. These tests include:

• MRI, to check your spinal nerves and look for disc problems.
• CT scan, to check your bones and joints.
• X-rays, to measure the extent of arthritis or injuries to the vertebrae.
• Bone scan, to rule out cancer and other bone diseases.
• Electromyogram and nerve conduction tests to see if other problems may be causing or adding to your symptoms.
• Myelogram, to look for narrowing of the spinal canal or abnormalities of the nerves branching off the canal. This is rarely used to diagnose spinal stenosis.

Your doctor may try nonsurgical treatment, such as pain-relieving medicines, exercise and physical therapy, for a period of time before ordering imaging tests. If treatment works, you may not need tests.

Imaging tests can help confirm a diagnosis or rule out other problems. But even if imaging shows spinal stenosis, your symptoms may not match the results of the tests. So treatment is based on what your symptoms are and how much spinal stenosis is impacting your life, not just on the results of imaging tests.