Spinal stenosis

Background

Clinical Features

  • Lower back pain that gets progressively worse over time
  • Pain relieved with forward flexion (walking uphill)
  • Pain worse with extension (walking downhill)

Differential Diagnosis

Differential diagnosis of back pain

Lower Back Pain

Evaluation

  • Check ankle-brachial index (ABI) to rule out vascular claudication

Management

  • Avoid alcohol and strengthen legs to prevent falls
  • Exercise bike or walking recommended with rest when pain comes
  • Pain control

Disposition

  • If no cauda equina and pain controlled → outpatient
  • As outpatient, can consider referral for decompressive laminectomy for severe persistent pain

See Also

External Links

References