Sara was not too happy when her doctor confirmed the diagnosis of spinal stenosis. Her MRI clearly shows the very narrow spinal canal at multiple levels. Her doctor was very careful to do a thorough nerve exam and check her pulses. Although she occasionally will experience numbness and tingling in her legs, today her nerves are working fine with no areas of numbness. Her pulses are strong. On his way out the door, her doctor said something about “neurogenic claudication” and told her to come back in 3 months.
That’s right, neurogenic claudication is caused by spinal stenosis. Quite simply, spinal stenosis causes a limping-type pain in the legs because the pinched nerves are unhealthy and unhappy. This similar aching pain in the legs can also be caused by clogged blood vessel—“vascular claudication”. The distinction between nerve and vascular problems is an important distinction to make because it affects the treatment. In this case, leaning forward on a shopping cart eased Sara’s pain; therefore, she most likely has neurogenic claudication. Her doctor knows about the “shopping cart sign” and confirmed the health of her blood vessels by checking her pulses. Still, poor Sara cannot walk around with a shopping cart all day. She needs a real solution to her spinal stenosis which seems to be getting worse every day.
The progressive nature of spinal stenosis has pushed researchers to develop innovative surgical and rehabilitation techniques. Fortunately, many types of treatment can ease the pain (See Spinal Stenosis: How Is It Treated?). Unfortunately, many areas of the spine can become abnormally narrow: the cervical spine, the thoracic spine, and the lumbar spine. Within each region of the spine, multiple levels can be affected. For example, lumbar spinal stenosis typically is found at L4/5 and L3/4. Pinpointing the exact level of the nerve damage is best done with an electrodiagnostic test (a special nerve test). This test is important because finding the right location helps to focus the treatment to one spot. Even with the best technology, the chances of successful treatment are complicated by the progressive, wide spread nature of spinal stenosis. Thankfully, the future holds promise for all types of spinal cord injuries, headline grabbing or not.