Bilateral Transforaminal Epidural Steroid Injections for Degenerative Lumbar Spinal Stenosis

Inclusion Criteria: * Symptoms of back/buttock/leg pain (NOT radicular pain) in a neurogenic claudicatory fashion, relieved by stooping or sitting down, for at least 3 months with no or poor response to conservative treatment (analgesics, NSAIDs, or physical therapy) * Patients with bilateral buttock and/or bilateral lower extremity pain in a neurogenic fashion with or without lower back pain * Radiologic documentation of degree of degenerative lumbar spinal stenosis (DLSS) * MRI/CT showing at least moderate central canal spinal stenosis (neuro-radiologist definition) with symptoms correlating with stenosis (symptoms of back/buttock/leg pain without unilateral radicular pain in a neurogenic claudicatory fashion, relieved by stooping or sitting down) * Patients choosing to receive BTESI as their next treatment option, following discussions with their spine doctor * Patients who can give informed consent, could tolerate the procedure, and who are able to understand and answer the forms and questionnaires properly. Exclusion Criteria: * Radiologic spinal stenosis without symptoms of spinal stenosis * Symptoms of neurogenic claudication without at least moderate degree of radiologic spinal stenosis * Patients with specific lumbo-sacral radicular symptoms or radiculopathy (radicular pain secondary to a single nerve root compression/inflammation; usually follows a specific dermatome in lower extremities; unilateral radiculopathy either from disc herniation or lateral recess stenosis) * Patients with vascular claudication (pain in the legs secondary to arterial insufficiency) * Previous lumbo-sacral surgery * Any condition that does not allow the patient to stand and/or walk for any length of time (e.g., COPD, severe lung disease, etc.) * Patients with symptomatic hip joint pathology concurrent with spinal stenosis * A coexisting musculoskeletal condition that would negate functional improvement from the injection (e.g., severe Parkinson disease, hemiparesis, etc.) * Malignancy or infection to the spine * Another pain generating condition that would mask the improvement provided by the injection * Patients who had lumbar epidural steroid injections within the past six months * Significant psychologic diagnosis and/or dementia * Patients receiving workman's compensation benefit * Patients unable to give consent on their own, or who are not able to understand and answer the forms and questionnaires, or their answers will not be reliable.