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Anne Asher

Spinal Stenosis - Is That What The Symptoms Say?

By May 15, 2012

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Spinal stenosis is closely associated with degenerative arthritis of the spine, and can be very difficult to live with.  As with many other back and neck conditions, diagnosing it early can help manage it successfully over time.

But the diagnosis process is not always straightforward.  According to Dr. Mark Ebell, Senior Editor of Essential Evidence Plus, a website that helps clinicians make evidence-based decisions, spinal stenosis "is a tough diagnosis to make".

In an Essential Evidence Plus POEM, Dr. Ebell summarized and commented on a 2010 systematic review of medical literature that looked to what degree specific symptoms (age, bilateral leg or butt pain, pain in certain positions, etc.) correlated with a diagnosis of spinal stenosis.

Interestingly, the reviewers were only able to locate 4 studies (involving 741  patients total).  Based on the fact that spinal arthritis is one of the most common types of arthritis (and arthritis is the leading cause of disability in the US), you would think the PTB would have arranged for more studies on diagnosing the stenosis that often results from it....

Anyway, the reviewers found that age (greater than 70 years), pain with walking, neurogenic claudication, bilateral butt or leg pain, unexpected urinary problems, no pain when sitting and pain relief when bending forward all correlated with a diagnosis of spinal stenosis, and most of them quite highly.  These signs and symptoms were obtained from the patients in the studies during the medical histories.  Their physical exams revealed that people who use a wide stance as their regular posture were more likely to have stenosis, as well.

This review also found that being younger than 60 and the absence of neurogenic claudication were correlated with not having spinal stenosis.

Sources:

Ebell and Wilkes. Useful signs and symptoms of lumbar spinal stenosis. Poem of the Week Podcast #154 Essential Evidence Plus. Accessed 5/15/12.

Pradeep Suri, MD; James Rainville, MD; Leonid Kalichman, PT, PhD; et al.  Does This Older Adult With Lower Extremity Pain Have the Clinical Syndrome of Lumbar Spinal Stenosis?  The Rational Clinical Examination JAMA. 2010;304(23):2628-2636

Comments
May 15, 2012 at 8:18 pm
(1) terrie brown-cox says:

Ive been diagnosed with spinal stenosis. Not a difficult diagnosis to give at all. My anasteiologist pain mng doctor ordered the CT scan after I was admitted to the emergency room with severe neck & arm pain. I already have degenerative disks which required a lumbar fusion surgery in 2007. After 3yrs of pretty good results it came back. A yr ago my doctor suggested a SCS be implanted. That consists of a small battery & leed wires being perm implanted in my right hip & back. I use a remote control to alliviate the pain in my leges & back thru stimulation. Now here comes the spinal stenosis. Ive done weeks of physical therapy which helped but now its back again. My next course of action? I dont know. Any suggestions to relieve my neck pain would be appriciated.

May 16, 2012 at 6:52 pm
(2) Nana says:

I am a back pain movement therapist and have helped a few of my clients that suffered from spinal stenosis managed their pain. Pilates is a very good remedy for spinal stenosis.

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