According to Mobility Matters: Landmark Survey on Chronic Low Back Pain (CLBP) in America1:

More than 72.3 million U.S. adults self-report that they have chronic low back pain...more than arthritis, diabetes, or heart disease.
27 million have never been told by an HCP exactly what causes their CLBP
78% of U.S. adults with CLBP DO NOT KNOW an enlarged ligament could be the cause
The Harris Poll Logo


Lumbar spinal stenosis, or LSS, is a common cause of low back and leg pain. In fact, there are 2.4 million U.S. patients in active treatment.2 LSS is generally found in people over the age of 50, and the likelihood of developing LSS increases with age. Learn more about LSS here.


Your back is a marvel of architecture—bone, muscle, and ligament working together to hold you up, move you through life, and protect the spinal canal which sends information to all parts of your body. Understanding that architecture can help you better understand how aging, degeneration, injuries, and other factors can lead to conditions that can cause low back and leg pain, like when an enlarged ligament compresses spinal nerves.

Animation of Muscle and Bone, with the Spine highlighted


Lumbar spinal stenosis (LSS) is a condition in which the lower spinal canal narrows and compresses the nerves in the lower back. Up to 85% of spinal canal narrowing is caused by an enlarged ligament.3


Best visualized as a “kink in a drinking straw,” this compression can contribute to pain and mobility issues.

Up close image of lumbar spinal stenosis and an enlarged ligament near the spine.


PAIN, NUMBNESS, tingling, or heaviness in the low back, legs, or buttocks when standing/walking.


TEMPORARY RELIEF when bending forward while sitting or standing as pressure on the spinal cord is released and space in the spinal canal is “opened.” Common actions include finding a chair, leaning over shopping cart, using walker or cane.

Man leaning over, pain in back. Woman leaning over a shopping cart with pain in her back.


The natural wear and tear on the spine as people age can lead to a number of contributing factors that cause the narrowing of the spinal canal and create pressure on the spinal nerves:


  • Enlarged Ligament
  • Bone Overgrowth
  • Disc Bulge
Healthy, open spinal canal
Aging spinal canal with stenosis
Diagnosis: How LSS is verified: Medical history and symptoms, physical examinations to test mobility, Imaging: MRI, CT scan, X-rays. 2.4 million U.S. patients in active treatment.


The following chart compares several options that are typically recommended for LSS patients when conservative therapies (eg, physical therapy, pain medication, chiropractic) are not providing adequate relief. Every therapy has risks and benefits. Only you and your doctor can decide which option is best for you.4

The Mild Procedure is the only treatment with a safety profile similar to an injection, and the lasting relief expected from back surgery. Chart: Column 1: Epidural Steroid Injections Complication Risk = Extremely Low (Low on Dial) Implants & Stitches = No Recovery & Post-Procedure Restrictions = Minimal (Low Bar) Typical Duration of Results = Temporary (Low Hourglass) Column 2: Mild Procedure Complication Risk = Extremely Low (Low Dial) Implants & Stitches = No Recovery & Post-Procedure Restrictions = Minimal (Low Bar) Typical Duration of Results = Lasting (Full Hourglass) Column 3: Spacer Implants Complication Risk = Moderate (Middle of Dial) Implants & Stitches = Yes Recovery & Post-Procedure Restrictions = Moderate (Middle of Bar) Typical Duration of Results = Lasting (Full Hourglass) Column 4: Open Surgery (Fusion, Laminotomy, Laminectomy) Complication Risk = Moderate/High (High on Dial) Implants & Stitches = Yes Recovery & Post-Procedure Restrictions = Moderate/Severe (High Bar) Typical Duration of Results = Lasting (Full Hourglass)

Healthcare professionals: To learn more about mild®

Patients: Download a free mild® brochure

Best Practices for Minimally Invasive Lumbar Spinal Stenosis Treatment 2.0 (MIST): Consensus Guidance from the American Society of Pain and Neuroscience (ASPN)

Published May 5, 2022

ASPN created a guidance for best practice for minimally invasive surgical treatment of symptomatic spinal stenosis. The paper includes explanations, advantages, and limitations of available treatment options.

ASPN American Society of Pain and Neuroscience Logo
papers of journal publications

A spine health doctor can help you determine the cause of your low back and leg pain, and provide you with treatment options that fit your needs.


1Mobility Matters: Low Back Pain in America, Harris Poll Survey, 2022. View data and full summary at knowyourbackstory.com. 2All payor claims analysis. 3Hansson T, Suzuki N, Hebelka H, Gaulitz A. The narrowing of the lumbar spinal canal during loaded MRI: the effects of the disc and ligamentum flavum. Eur Spine J. 2009;18(5):679-686. Doi:10.1007/s00586-009-0919-7. 4Jain S, Deer TR, Sayed D, et al. Minimally invasive lumbar decompression: a review of indications, techniques, efficacy and safety. Pain Manag. 2020;10(5). https://doi.org/10.2217/pmt-2020-0037. Accessed June 1, 2020.
View outcomes, data, full citations, and safety information at www.Vertosmed.com.