Numerous approaches including surgery for the release of cauda equina compression symptoms due to vertebral canal stenosis are well known. The successful use of spinal manipulative therapy for reduction of neurogenic claudication symptoms is discussed in this case presentation. An elderly male presents with vague leg pain and paresthesias of the left lower extremity precipitated by walking. A brief discussion of the etiology, symptomatology and diagnosis of claudication is made. Methods of differential diagnosis of vascular vs. neurogenic claudication are discussed.