Neurogenic Claudication

Overview

Neurogenic claudication is a symptom caused by central lumbar stenosis. Most of the time the stenosis is at L4-5, L3-4, or L2-3 with a combination of one or two continuous levels. Most patients present with stenosis at L4-5 alone, or L3-4 and L4-5.

Symptoms usually start as generalized back pain across the lower back, made worse with standing, walking, and extension. Over time, the patient or a family member may notice the patient is frequently hunched or flexed forward a few minutes after standing from a seated position. As they begin walking, the pain worsens while flexion begins to relieve it.

When you see someone walking severely hunched over, they most likely have neurogenic claudication. Pain then travels down the legs bilaterally, sometimes affecting the anterior leg, posterior leg, or both. Once the patient sits down, symptoms begin to subside.

Stenosis is a component of degenerative disc disease and can include a central disc herniation or facet hypertrophy. Enlargement of the facet joint can be very painful, adding to the back pain. Compression of the nerves from lumbar stenosis causes leg pain or neurogenic claudication. Once symptoms start, they usually worsen over time.

Symptoms

Content pending medical review.

Causes

Content pending medical review.

When to see a specialist

Content pending medical review.

Non surgical treatment options

We offer comprehensive non surgical treatment plans tailored to each patient's condition, focused on pain relief, mobility improvement, and overall spinal health. While we do not perform these treatments in house, we collaborate with trusted local specialists to ensure you receive the highest level of care.

Physical therapy

We develop personalized physical therapy prescriptions based on your specific needs and refer you to experienced local providers. These programs are designed to improve strength, flexibility, and posture, helping to reduce pain and enhance mobility while promoting long term spinal health.

Epidural injections

For patients who may benefit from epidural steroid injections, we provide expert evaluations and referrals to trusted local physicians who specialize in pain management. These injections can reduce inflammation and nerve related pain caused by conditions such as herniated discs and spinal stenosis, offering significant relief with minimal downtime.

Chiropractic care and acupuncture

Chiropractic care can help patients with leg pain as a component of their condition. Acupuncture works best in the presence of severe muscle spasms. Both are considered alongside physical therapy and medication as part of a comprehensive conservative plan.

View all non surgical options →

Common treatments include non steroidal anti inflammatory agents, physical therapy, and epidural injections. Acupuncture and chiropractic care can help. Patients are also candidates for facet blocks. Patients can find relief from an epidural injection in the region of the stenosis. If successful, physiatrists may inject up to three times in a twelve month period.

Surgical options

Patients are initially evaluated by a physiatrist to ensure all non surgical options, including physical therapy and non narcotic pain management, are exhausted before considering a surgical solution.

View all surgical options →

Recovery

Content pending medical review.