Pain, cramping, tingling sensations, and general weakness in the lower extremities that contributes to difficulty walking are among the common symptoms associated with neurogenic claudication, a condition often associated with a narrowing of the lower spine, also referred to as lumbar spinal stenosis. Restriction of the spinal canal may be further affected by existing herniated discs or bone spurs in the lower spine. Here’s what you need to know about neurogenic claudication.
How Does Neurogenic Claudication Affect the Spine?
Neurogenic claudication affects the lower spine and nerve roots in this area in a way that primarily affects gait. For instance, you may begin to have difficulty climbing stairs or steadying yourself without holding onto a rail or paying careful attention to your movements. Gait is also affected due to limitations with extension and flexion of the spinal canal, which forces you to move your spine back and pull your neck away from your chest. Symptoms may only be noticeable on one side of the body, or both sides may be affected (depending on the specific area of nerve compression). The compression of nerve roots around the lower spine may also contribute to symptoms that include:
- Radiating discomfort in the hips, thighs, or buttocks
- Muscle weakness extending to arms or legs
- Discomfort that’s distracting enough to cause limping
What Are the Contributing Factors?
Since flexion naturally widens the spinal canal, another common characteristic of neurogenic claudication is pain that often goes away when sitting down or bending forward. However, symptoms may become increasingly problematic when standing or walking for long periods. Contributing factors, both preventable and non-preventable, that may increase the risk of developing this condition include:
- Years of physically demanding work
- Age-related wear
- Sudden trauma or injury
- Genetic predisposition
- Poor posture
- Lifestyle factors (e.g. excess weight, smoking)
How Is Neurogenic Claudication Treated?
Since neurogenic claudication is mainly caused by a narrowing of the lower spine, treatment options are similar to what’s normally recommended for patients with spinal stenosis. This typically means activity modification, the use of canes or other assistance devices, and exercises that strengthen muscles within the affected area. Patients may also benefit from:
- Over-the-counter or prescription anti-inflammatory drugs
- Epidural injections with a steroid solution that temporarily eases pain
- Weight management
- Hot and cold therapy
- Chiropractic manipulation
- Gentle forms of exercise (e.g. yoga, Pilates, water-based exercises)
- Alternative treatments such as acupuncture and mindful meditation
Is Surgery Necessary?
If conservative remedies aren’t effective or mobility is severally affected, a surgeon may recommend minimally invasive spine surgery. Beverly Hills patients with neurogenic claudication may need to undergo a procedure that free space for nerves in the lower spine. Options include:
- Lumbar laminectomy – Removal of part of a vertebral arch (lamina)
- Facetectomy or foraminotomy – All or part of a bony structure in the spinal canal is removed
- Microendoscopic decompression – A newer procedure done through a tube to minimize soft tissue trauma
- Facet replacement/total element replacement – Replacement of affected spinal discs without fusion
As may be the case with sciatica, which produces similar symptoms, many patients with neurogenic claudication often learn to make modifications to normal movements to minimize discomfort. If you’re experiencing pain that’s getting worse or having more difficulty with mobility, talk to your doctor or a Beverly Hills spine surgeon about treatment options you might not have considered that could provide relief. If you have additional questions about neurogenic claudication, get in touch with The Spine Institute today at 310-828-7757.