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Neurogenic Claudication & Leg Pain

Neurogenic claudication is commonly described as pain or discomfort that radiates into the buttocks, thigh and lower leg, [Katz, 2008] which is typically worsened by standing, walking and lumbar extension, and alleviated with lumbar flexion or sitting [Katz, 1995]. Neurogenic claudication is associated with degenerative lumbar spinal stenosis, an anatomic condition in which the spinal canal is narrowed by degenerative changes of spinal structures, resulting in compression of the dural sac and lumbar nerve roots [Arnoldi, 1976, Herkowitz, 1976, Amundsen 1995-7]. Neurogenic claudication may be accompanied by transient or persistent lower extremity neurological symptoms including impaired sensation, strength and balance [Katz, 1995].  Neurogenic claudication and related neurological symptoms often come on gradually and can progressively worsen with the passage of time.  Neurogenic claudication is common in the elderly, but uncommon in young or middle age adults. At the El Paso Pain Center we have board-certified specialists that can help diagnose and treat this condition. The diagnosis is typically made by a combination of history, physical exam and imaging. Some of the treatments we can offer for this condition include physical therapy, aquatherapy, medications, assistive devices, epidural steroid injections and/or neuromodulation.

 

References:

Arnoldi CC, Brodsky AE, Cauchoix J, et al. Lumbar spinal stenosis and nerve root entrapment syndromes. Definition and classification. Clin Orthop Relat Res 1976;115:4-

Herkowitz HN. Spine update. Degenerative lumbar spondylolisthesis. Spine 1976;20:1084-90.

Amundsen T, Weber H, Lilleas F, Nordal HJ, Abdelnoor M, Magnaes B. Lumbar spinal stenosis. Clinical and radiologic features. Spine 1995;20:1178-86.

Kalichman L, Cole R, Kim DH, et al. Spinal stenosis prevalence and association with symptoms: the Framingham Study. Spine J 2009;9:545-50.

Katz JN, Harris MB. Clinical practice. Lumbar spinal stenosis. The New England journal of medicine 2008;358:818-25.

Katz JN, Dalgas M, Stucki G, et al. Degenerative lumbar spinal stenosis: diagnostic value of the history and physical examination. Arthritis Rheum 1995;38 1236-41

Rainville J, Lopez E. “Comparison of Radicular Symptoms Caused by Lumbar Disc Herniation and Lumbar Spinal Stenosis in the Elderly.” Spine. 38(15):1282-1287, July 01, 2013.

ABOUT AUTHOR

by Dr.Edrick Lopez

Dr. Edrick Lopez received his medical degree from the University of Puerto Rico School of Medicine where he also obtained a law degree. He completed his residency of Physical Medicine and Rehabilitation at Harvard Medical School. Dr. Lopez then completed his fellowship at the University of Texas Health Science Center of San Antonio and is Double Board Certified.

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