Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment

Table of ContentsView All

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Table of Contents

Symptoms

Causes

Diagnosis

Treatment

Neurogenic claudicationoccurs when spinal nerves get compressed in the lumbar (lower) spine, causing intermittent leg pain. Also known aspseudoclaudication, it typically occurs when the space within the bones of thelumbar spinegets too small—a condition referred to aslumbar spinal stenosis.

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Spinal stenosis often affects seniors and the elderly.

Neurogenic Claudication Symptoms

Symptoms of neurogenic claudication include:

Leg pain from neurogenic claudication is intermittent and changes with specific movements or activities. Standing, walking, descending stairs, or flexing the spine backward can cause pain. Or, sitting, climbing stairs, or leaning forward tend to relieve pain.

Over time, neurogenic claudication can affect a person’s mobility as they avoid any activity that causes pain, including exercise, lifting heavy objects, and prolonged walking. Even sleep may become a challenge.

In severe cases, neurogenic claudication can lead to the loss of bladder or bowel control due to the compression of nerves that regulate these functions.

With neurogenic claudication, compressed spinal nerves are the underlying cause of leg pain. In the majority of cases, lumber spinal stenosis (LSS) is the cause ofradiculopathy, or pinched nerve symptoms. There are two types:

LSS can either beacquired(something that develops in later life due to deterioration of the spine) orcongenital(something you are born with).Each can lead to neurogenic claudication in slightly different ways.

Acquired LSS

LSS is generally acquired due to the degeneration of the lumbar spine. The causes of the narrowing of the spinal canal are many and include:

Because it is largely aging-related, LSS tends to affect older adults, particularly those in their 60s and 70s. As neurogenic claudication is generally the result of spinal deterioration, the symptoms are usually permanent. Pain can be minimized with treatment, however.

Congenital LSS

With congenital LSS, a person is born with subtle abnormalities of the spine that may not be readily apparent at birth. But, because the space within the canal is already narrow, the spinal cord is vulnerable to any changes that can occur as the person gets older.

Even if a person only has mild arthritis, they can experience symptoms of neurogenic claudication years before people with normal spines do. As a result, people with congenital LSS tend to develop symptoms in their 30s and 40s rather than their 60s and 70s.

Congenital LSS is also common in people withachondroplasia(the most common cause of dwarfism) due to the smaller size of their spine.

Neurogenic Claudication vs. Vascular ClaudicationNeurogenic claudication should not be confused with vascular claudication in which blood flow to the arms or legs is severely restricted, causing pain (usually in one limb).

Neurogenic Claudication vs. Vascular Claudication

Neurogenic claudication should not be confused with vascular claudication in which blood flow to the arms or legs is severely restricted, causing pain (usually in one limb).

There is no gold standard for the diagnosis of neurogenic claudication. The diagnosis is largely based on the person’s medical history, a physical exam, and medical imaging.

The physical exam and review are aimed at identifying where the pain is felt and when. Your healthcare provider may ask:

Your healthcare provider will likely order imaging tests to see if there are any signs of LSS.

While a spinal X-ray orcomputed tomography (CT)scan is useful in diagnosing LSS, amagnetic resonance imaging (MRI)scan may be preferred because it is better able to image soft tissues, such as those of the spinal cord. MRI is generally considered reliable in LSS diagnosis.

Neurogenic Claudication Treatment

Treatment for neurogenic claudication usually is conservative and back surgery is considered a later option. These treatment options include the following:

A type of back surgery known as alaminectomycan be used to decompress the lumbar spine if other treatments don’t work and symptoms significantly impact quality of life.

The procedure may be performedlaparoscopically(with tiny incisions and pen-like scopes and surgical instruments) or asopen surgery(with a scalpel and sutures).

During a laminectomy, facets of the vertebra are either partially or completely removed. To aid with stability, the bones are sometimesfusedwith screws, plates, or rods and pieces of bones harvested from the pelvis.

Success rates for open and laparoscopic laminectomy are more or less the same. Between 85% and 90% of people who undergo the surgery achieve long-lasting or even permanent pain relief.

Improved Walking With ClaudicationProblems with walking are a hallmark sign of claudication due to LSS. An improved walking distance is a key goal of treatment. Walking can be good for people with neurogenic claudication but the exercise may require supervision in some people, such as treadmill walking with your body weight supported during physical therapy sessions.

Improved Walking With Claudication

Problems with walking are a hallmark sign of claudication due to LSS. An improved walking distance is a key goal of treatment. Walking can be good for people with neurogenic claudication but the exercise may require supervision in some people, such as treadmill walking with your body weight supported during physical therapy sessions.

Summary

Neurogenic claudication occurs when nerves get pinched within the center of the lumbar spine, causing intermittent leg pain. It is a characteristic feature of spinal stenosis, in which the passages inside the lumbar spine get narrow. The pain typically gets worse with specific movements.

The treatment of neurogenic claudication is typically conservative and may involve oral painkillers, physical therapy, occupational therapy, or, in severe cases, spinal steroid injections. Back surgery is a last resort when all other options fail.

8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ,et al.Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review.BMJ Open. 2022 Jan 19;12(1):e057724. doi:10.1136/bmjopen-2021-057724Columbia University Irving Medical Center.Neurogenic Claudication.Norimoto M, Eguchi Y, Kanamoto H, Oikawa Y, Matsumoto K, Masuda Y,et al.Diffusion Tensor Imaging of the Spinal Canal in Quantitative Assessment of Patients with Lumbar Spinal Canal Stenosis.Asian Spine J. 2021 Apr;15(2):207-215. doi:10.31616/asj.2020.0026Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE,et al.Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical Practice Guideline.J Pain. 2021 Sep;22(9):1015-1039. doi: 10.1016/j.jpain.2021.03.147Lafian AM, Torralba KD.Lumbar Spinal Stenosis in Older Adults.Rheum Dis Clin North Am. 2018 Aug;44(3):501-512. doi: 10.1016/j.rdc.2018.03.008Ma X-L, Zhao X-W, Ma J-X, Li F, Wang Y, Lu B.Effectiveness of surgery versus conservative treatment for lumbar spinal stenosis: A system review and meta-analysis of randomized controlled trials.International Journal of Surgery. 2017;44:329-338. doi:10.1016/j.ijsu.2017.07.032Cai H, Omara C, Vleggeert-Lankamp CLA.Association Between Radiological Severity of Lumbar Spinal Stenosis and Spinopelvic Parameters in Adult Patients With Achondroplasia.Neurosurgery. 2024 May 29. doi:10.1227/neu.0000000000003007Banitalebi H, Espeland A, Anvar M, Hermansen E, Hellum C, Brox JI,et al.Reliability of preoperative MRI findings in patients with lumbar spinal stenosis.BMC Musculoskelet Disord. 2022 Jan 15;23(1):51. doi:10.1186/s12891-021-04949-4Additional ReadingMeyer B, et al.Percutaneous Interspinous Spacer vs Decompression in Patients with Neurogenic Claudication: An Alternative in Selected Patients?Neurosurgery. 2018.

8 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ,et al.Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review.BMJ Open. 2022 Jan 19;12(1):e057724. doi:10.1136/bmjopen-2021-057724Columbia University Irving Medical Center.Neurogenic Claudication.Norimoto M, Eguchi Y, Kanamoto H, Oikawa Y, Matsumoto K, Masuda Y,et al.Diffusion Tensor Imaging of the Spinal Canal in Quantitative Assessment of Patients with Lumbar Spinal Canal Stenosis.Asian Spine J. 2021 Apr;15(2):207-215. doi:10.31616/asj.2020.0026Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE,et al.Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical Practice Guideline.J Pain. 2021 Sep;22(9):1015-1039. doi: 10.1016/j.jpain.2021.03.147Lafian AM, Torralba KD.Lumbar Spinal Stenosis in Older Adults.Rheum Dis Clin North Am. 2018 Aug;44(3):501-512. doi: 10.1016/j.rdc.2018.03.008Ma X-L, Zhao X-W, Ma J-X, Li F, Wang Y, Lu B.Effectiveness of surgery versus conservative treatment for lumbar spinal stenosis: A system review and meta-analysis of randomized controlled trials.International Journal of Surgery. 2017;44:329-338. doi:10.1016/j.ijsu.2017.07.032Cai H, Omara C, Vleggeert-Lankamp CLA.Association Between Radiological Severity of Lumbar Spinal Stenosis and Spinopelvic Parameters in Adult Patients With Achondroplasia.Neurosurgery. 2024 May 29. doi:10.1227/neu.0000000000003007Banitalebi H, Espeland A, Anvar M, Hermansen E, Hellum C, Brox JI,et al.Reliability of preoperative MRI findings in patients with lumbar spinal stenosis.BMC Musculoskelet Disord. 2022 Jan 15;23(1):51. doi:10.1186/s12891-021-04949-4Additional ReadingMeyer B, et al.Percutaneous Interspinous Spacer vs Decompression in Patients with Neurogenic Claudication: An Alternative in Selected Patients?Neurosurgery. 2018.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ,et al.Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review.BMJ Open. 2022 Jan 19;12(1):e057724. doi:10.1136/bmjopen-2021-057724Columbia University Irving Medical Center.Neurogenic Claudication.Norimoto M, Eguchi Y, Kanamoto H, Oikawa Y, Matsumoto K, Masuda Y,et al.Diffusion Tensor Imaging of the Spinal Canal in Quantitative Assessment of Patients with Lumbar Spinal Canal Stenosis.Asian Spine J. 2021 Apr;15(2):207-215. doi:10.31616/asj.2020.0026Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE,et al.Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical Practice Guideline.J Pain. 2021 Sep;22(9):1015-1039. doi: 10.1016/j.jpain.2021.03.147Lafian AM, Torralba KD.Lumbar Spinal Stenosis in Older Adults.Rheum Dis Clin North Am. 2018 Aug;44(3):501-512. doi: 10.1016/j.rdc.2018.03.008Ma X-L, Zhao X-W, Ma J-X, Li F, Wang Y, Lu B.Effectiveness of surgery versus conservative treatment for lumbar spinal stenosis: A system review and meta-analysis of randomized controlled trials.International Journal of Surgery. 2017;44:329-338. doi:10.1016/j.ijsu.2017.07.032Cai H, Omara C, Vleggeert-Lankamp CLA.Association Between Radiological Severity of Lumbar Spinal Stenosis and Spinopelvic Parameters in Adult Patients With Achondroplasia.Neurosurgery. 2024 May 29. doi:10.1227/neu.0000000000003007Banitalebi H, Espeland A, Anvar M, Hermansen E, Hellum C, Brox JI,et al.Reliability of preoperative MRI findings in patients with lumbar spinal stenosis.BMC Musculoskelet Disord. 2022 Jan 15;23(1):51. doi:10.1186/s12891-021-04949-4

Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ,et al.Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review.BMJ Open. 2022 Jan 19;12(1):e057724. doi:10.1136/bmjopen-2021-057724

Columbia University Irving Medical Center.Neurogenic Claudication.

Norimoto M, Eguchi Y, Kanamoto H, Oikawa Y, Matsumoto K, Masuda Y,et al.Diffusion Tensor Imaging of the Spinal Canal in Quantitative Assessment of Patients with Lumbar Spinal Canal Stenosis.Asian Spine J. 2021 Apr;15(2):207-215. doi:10.31616/asj.2020.0026

Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE,et al.Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical Practice Guideline.J Pain. 2021 Sep;22(9):1015-1039. doi: 10.1016/j.jpain.2021.03.147

Lafian AM, Torralba KD.Lumbar Spinal Stenosis in Older Adults.Rheum Dis Clin North Am. 2018 Aug;44(3):501-512. doi: 10.1016/j.rdc.2018.03.008

Ma X-L, Zhao X-W, Ma J-X, Li F, Wang Y, Lu B.Effectiveness of surgery versus conservative treatment for lumbar spinal stenosis: A system review and meta-analysis of randomized controlled trials.International Journal of Surgery. 2017;44:329-338. doi:10.1016/j.ijsu.2017.07.032

Cai H, Omara C, Vleggeert-Lankamp CLA.Association Between Radiological Severity of Lumbar Spinal Stenosis and Spinopelvic Parameters in Adult Patients With Achondroplasia.Neurosurgery. 2024 May 29. doi:10.1227/neu.0000000000003007

Banitalebi H, Espeland A, Anvar M, Hermansen E, Hellum C, Brox JI,et al.Reliability of preoperative MRI findings in patients with lumbar spinal stenosis.BMC Musculoskelet Disord. 2022 Jan 15;23(1):51. doi:10.1186/s12891-021-04949-4

Meyer B, et al.Percutaneous Interspinous Spacer vs Decompression in Patients with Neurogenic Claudication: An Alternative in Selected Patients?Neurosurgery. 2018.

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