Lumbar Stenosis with Neurogenic Claudication
The spine is one of the most important elements of the human body. When it stops working properly, it can cause tremendous pain. Moreover, it can also affect other parts of the human body, especially the legs. This is why it’s so crucial to address and diagnose all spinal problems in time.
If you feel pain and stiffness in your leg that eases when you sit down, you might suffer from neurogenic claudication.
What Is Neurogenic Claudication?
Neurogenic means that the problem appears in the nervous system. Claudication is a word to describe leg pain or heaviness, especially while walking. This problem can appear when there is a compression of the spinal nerves in the lower part of your spine.
This type of claudication is different from vascular claudication. The second one is caused by reduced blood flow to the leg.
What Are the Symptoms of Neurogenic Claudication?
Some of the most common neurogenic claudication symptoms appear mostly in the back or one or both legs and include:
Those symptoms can be also noticed in the hips or buttocks. People who suffer from neurogenic claudication can also feel that their legs are weak or heavy. Affected people often notice that those symptoms ease while leaning forward or sitting down. This can increase while standing upright and walking.
What Connects Neurogenic Claudication and Lumbar Stenosis
Neurogenic claudication is considered one of the main symptoms of lumbar stenosis. The first former is rather an effect of the problem, rather than its core. Lumbar stenosis is a health condition in which the canals that protect the nerve or the spinal cord narrow in the lower back area. When space is narrower, the nerve cannot travel freely down the spine to other parts of the body, for example, the legs.
There are some factors that can cause this disorder at a young age. However, most people who suffer from lumbar stenosis are 60 years old or higher. Simply put, this disorder affects people as they grow older.
With age, bones and joints thicken. The discs that connect vertebrae can lose their water. Because of that, they no longer play their crucial role which is absorbing shocks between the vertebrae.
When you sit down or lean, you can feel pain relief. It happens because while sitting you can stretch the spine. By doing so, you force the spaces of your spine to open up and take off the pressure from the nerves.
Causes and Risk Factors
The main cause of neurogenic claudication is spinal stenosis, or put more simply, narrowing of the spinal canal in the lower back (lumbar area). Some of the most common causes of spinal stenosis are arthritic changes and wear and tear in the lower spine.
Those changes can lead to bulging discs, overgrowth of bone spurs, and thickening of ligaments. Stenosis may press on the nerve roots that are responsible for feeling and movement of the lower body. This compressing can cause prolonged pain, tingling, and cramping.
The pain intensifies while standing because in this position the spinal canals are naturally narrower. That causes extra pressure on the nerve roots. You can temporarily ease the pain by flexing forward or sitting. Remember that it’s only a temporary solution and is not going to solve your problem. You need professional medical attention.
Neurogenic Claudication Test and Diagnosis
The best way to know if you suffer from neurogenic claudication is by consulting a specialist. You need to have thorough physical exams, connected with detailed interviews. This way a physician can determine where your pain comes from, and what type of pain it is.
Some of the symptoms allow a medical expert to recognize if you suffer from vascular claudication or a neurogenic one. One of the main differences between those two is that in the case of vascular claudication, the pain often eases after resting, while in neurogenic claudication, discomfort is relieved for a while when in a particular position.
To confirm a diagnosis of neurogenic claudication, you might need to participate in a few tests. They can determine the cause of your pain and better prepare you for treatment.
Some of the most common tests that are run when spinal stenosis is suspected are:
- X-Ray: This test uses electromagnetic energy beams, known as X-rays, to show the image of bones. X-rays can provide an image of the bone anatomy and curvature of the vertebral column. It’s a great tool to check spinal discoloration and slippage. X-rays can be useful in confirming Kyphosis and scoliosis. Other things that are visible on the X-ray are bone abnormalities, for example, a narrowed disc space, bone spurs, erosion, collapse, and fracture of a vertebral body. A doctor can recommend dynamic or extension X-rays. This test can show the spine in motion. Thanks to this more advanced scanning, a medical doctor can verify if there are any abnormalities, such as excessive movement or instability in the spine. Through the X-ray test, it’s impossible to see soft tissues, such as spinal nerves, the disc, spinal cord, or ligaments. A doctor is also not going to see tumors, cysts, or vascular malformation.
- Magnetic resonance imaging, also known as MR, is a test that uses large magnets and radiofrequencies to show images of bones and soft tissues on a computer. It can help check if the stenosis is caused by a herniated disc or bulging.
- Computer tomography scan uses X-rays and a computer to show images of soft tissues and bones.
Based on your symptoms and effects of testing, a doctor can identify your problem and decide which method of treatment would be the best for you.
Can Neurogenic Claudication Lead to Disability?
As your spine is a very important part of the body, you have to act fast. Otherwise, you risk severe health problems or even disability. According to statistics, neurogenic claudication caused by lumbar spinal stenosis can lead to disability. It is the problem that causes most spinal surgeries among older people, and it is also considered one of the most common causes of disability among this group.
The most effective way to get rid of neurogenic claudication is by surgery. During the treatment, the nerve roots in the lumbar spine are decompressed. It might happen that if the compression that was affecting the spine caused a herniated disc, a microdiscectomy procedure might be necessary. In other cases, a process of laminectomy is very often necessary, when the part of a bone is removed.
Spinal implants can make the surgery less traumatic. A spinal implant is a very useful device that can reduce back pain. When you suffer from any disorder in your spinal column, you might benefit from it. The device can be surgically placed in between your vertebrae and you can manage it remotely once you feel the pain. You are going to send low-level electrical impulses to the spinal cord.
Thanks to this, you can stimulate your spine and reduce pain. This solution is ideal for anyone for whom the nonsurgical method of reducing pain doesn’t work. Spinal implants can be a great solution for people who suffer from neurogenic claudication and are looking for a long-lasting solution for their problem and pain.