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Lumbar Spinal Stenosis
November 2000

Q. I am 66 years old and have been diagnosed with lumbar spinal stenosis. From all that I have read on this topic, I don't seem to have the symptoms. I do have severe pain in the back of my right thigh when I am active, but I don't experience much pain when I sit or lie down. I could stay in a recliner or on a bed and probably not have to take pain medication. What is your take on this?

A. Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back. This frequently results in low back and leg pain induced by standing or walking, and relieved by sitting or lying down. The leg pain is usually bilateral, but not always. It is usually caused by arthritis/degenerative changes of the spine that compress the spinal cord. Weakness, and/or numbness of the legs and urinary difficulty may also occur. Diagnosis is usually confirmed by MRI of the low back. Treatment is often effective. Conservative treatment includes use of anti-inflammatory meds such as Naprosyn or Motrin, and physical therapy. If this does not alleviate the symptoms, or if there is significant neurologic deterioration, then surgical treatment may be required. Another possibility that may cause leg pain with activity is impaired circulation (vascular claudication). Often physical exam of pulses in the legs and feet can exclude this. If doubt still exists, and arterial ultrasound of the legs can be done to assess circulation.

Many patients can return to an active life after treatment of the above conditions. Hope this helps

Ref: Harrison's Principles of Internal Medicine.

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