Dr. Matthew Cunningham, Spine Surgeon, Answers Your Questions About Back Pain & Spine Conditions: Part Two

Man Experiencing Back Pain

Answers written by: Dr. Matthew Cunningham, Spine Surgeon

Q4. Curious to find out more about spinal stenosis. My aging father has suffered from back pain for some time and was just diagnosed with this.

Spinal stenosis is a condition where the nerves do not have enough “room” inside the spinal canal to work properly. It is a gradually progressive condition that tends to happen to patients in their 50s and up, and usually involves decreased walking tolerance, “heaviness” in the legs, and sometimes pain and “sciatica” that shoots down the legs. He should be checked out so that a treatment plan can be developed, which may include: physical therapy, non-steroidal antiinflammatories, epidural steroid injections, or is all of these are ineffective, surgery.

Q5. I had spinal fusion surgery at your hospital early December by Dr. Farmer, who was the best! I’m going for PT but wanted to know do’s and don’ts for now. I forgot to ask Dr. Farmer when I just saw him, and don’t want to hurt myself. I really want to know my limitations.

Mobilizing after surgery is very dependent on the details of what you’d had done, and the personal feelings of your surgeon. I will recommend that you speak to your surgeon about how they want you to proceed with mobilizing. For the first 6 weeks, I encourage my patients to “remain vertical” as much as they are able to tolerate: shoulders over the hips – standing, sitting, and walking. I don’t want to start up trunk strengthening exercises too early, and I don’t want to get the range of motion going too early, because I want the spine to be healing pretty well before we start to stress it with vigorous muscle activity.

Matthew E Cunningham MD PhD
is an orthopedic surgeon at HSS, specializing in Pediatric and Adult, Spine and Scoliosis surgery. Dr. Cunningham’s interests include minimally invasive and open surgery for spine deformity and degenerative conditions. He currently is the Interim Chief of the Scoliosis Service, Director of the John Cobb Scoliosis Fellowship, Principal Investigator of the Molecular and Cellular Spine Research Laboratory at HSS, and acts as a reviewer for Clinical Orthopedics & Related Research, Hospital for Special Surgery Journal, Journal of Orthopedic Research, Arthritis Research & Therapy Journal, Scoliosis Journal, Biochemistry Journal, American Academy for Laboratory Animal Science Journal, and Journal of Biomechanics.

Topics: Orthopedics
The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.


  1. Can you treat a person who has End Plate degeneration and signal abnormalities? Is there anything that can be done to alievate constant pain?

    1. Hi Carol, thank you for reaching out. Dr. Han Jo Kim, Orthopedic Surgeon, says: “Yes. It depends on the presence or absence of nerve compression. Usually, there are a variety of non-operative and operative treatment methods to treat this condition.” If you are interested in care at HSS, please contact our Physician Referral Service at 877-606-1555 for assistance.

  2. I have sciatica in both legs, causing much pain. I am an 81 year old woman with bad back problems and a lung disorder that prohibits surgery. Previously, I have had epidurals, which are no longer effective after about 6 weeks. I would like to see a doctor who can help me–and who takes Medicare.

  3. What do you think of the x stop procedure
    for the treatment of spinal stenosis? My father has great difficulty walking, and this seems to be a minimally invasive procedure. Can this procedure be done
    without general anesthesia?

    1. Hi Elizabeth, Thanks for your comment. For well-selected patients, there is research to support good results using the technique. It is best to consult with your father?s physician regarding if he is a candidate for this procedure and anesthesia used. If you?d like to make an appointment with an HSS physician, contact our Physician Referral Service at +1.877.606.1555 or https://www.hss.edu/secure/prs-appointment-request.asp?pageid=6463.

If you’d like to consider HSS for treatment, please contact our Patient Referral Service at 888-720-1982. For general questions and comments, reach us on Facebook or Twitter.