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Diagnosis of neurogenic claudication is based on typical clinical features, the physical exam, and findings of spinal stenosis on computer tomography (CT) or X-ray imaging. [1] In addition to vascular claudication, diseases affecting the spine and musculoskeletal system should be considered in the differential diagnosis. [9]
The first symptoms of stenosis include bouts of low back pain. After a few months or years, this may progress to claudication. The pain may be radicular, following the classic neurologic pathways. This occurs as the spinal nerves or spinal cord become increasingly trapped in a smaller space within the canal.
Claudication is a medical term usually referring to impairment in walking, or pain, discomfort, numbness, or tiredness in the legs that occurs during walking or standing and is relieved by rest. [1] The perceived level of pain from claudication can be mild to extremely severe.
Weight loss, to relieve symptoms and slow the progression of the stenosis; Physical therapy to support self-care. [37] Also may give instructions on stretching and strength exercises that may lead to a decrease in pain and other symptoms. Lumbar epidural steroid or anesthetic injections have low quality evidence to support their use. [36] [38]
Losing weight can nix this risk factor for low back pain by decreasing the demand on your spinal structures, says Dr. Landon Uetz, PT, DPT, a physical therapist at TeachMe.To.
[1] [2] Waddell's signs may indicate non-organic or psychological component to chronic low back pain. Historically they have also been used to detect malingering in patients with back pain. While testing takes less than one minute, [2] it has been described as time-consuming and alternatives have been proposed. [3]
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