The back is made up of the spine (small bones called vertebrae stacked on top of each other), discs, ligaments and muscles. As we age it’s normal for changes to our spine to occur, but they aren’t always painful.
Back pain can range from a dull ache to a sharp or stabbing sensation. It may also feel like it’s radiating down your legs (called sciatica).
A herniated disk happens when the tough fibrous outer wall of a disc in your spine tears or ruptures, and the gel-like center bulges out through the opening. This can put pressure on nerves that travel through the spinal canal. This can cause pain, numbness or weakness in the part of your body that the nerve affects. Herniated disks most often occur in the lower (lumbar) part of your spine. Generally, they develop as a result of injury or improper lifting. However, herniated discs can also be caused by aging, smoking and repetitive strenuous activities.
A physical exam is the first step in diagnosing a herniated disc. Your doctor will ask you about your past injuries and symptoms. Then he or she will examine your neck, shoulders, arms and hands, back, hips and legs. Your doctor may suggest an imaging test to help find the location of your herniated disc. These tests include X-rays, computed tomography (CT) scan and magnetic resonance imaging (MRI). These exams provide clear pictures of the bones of your spine. They can show whether your vertebrae are too close together or whether you have bone spurs, a spinal infection or other problems.
MRI provides the most accurate picture of a herniated disk. It can reveal the extent of damage to your spine and locate herniated discs. In addition, MRI can reveal the presence of other back problems such as spinal stenosis or a bone fracture.
In some cases, a herniated disk can be treated without surgery. This includes taking pain medications, improving your posture and avoiding activities that can lead to herniations. You should also do strengthening and flexibility exercises.
If conservative treatments are ineffective, your doctor may recommend surgery to relieve herniated discs. The most common surgeries used to treat herniated discs are a laminotomy and a spinal decompression procedure called a discectomy. In a laminotomy, your surgeon makes an opening in the vertebral arch (lamina) to relieve pressure on your spinal nerves. In a spinal decompression, your surgeon removes the portion of the herniated disk that is pressing on a nerve. This can be done through a small incision or with the help of a microscope.
Over time, the spinal discs may degenerate. Degeneration happens when the soft jellylike core of the disc begins to break down or crack. The outer layer of the disk, called the annulus fibrosis, contains nerves. When a disk breaks down or ruptures, it can press on the nerves of the spinal cord and cause pain. Degenerated disks are a common condition that can lead to herniated disks, back pain and stiffness. The pain can be sharp, nagging or constant, and it comes and goes. It can also be felt in the arms or legs. Symptoms vary from person to person, but usually include pain that is worse when sitting or certain movements and pain that radiates down the hips, thighs and legs.
Degeneration of the spinal discs is a normal part of the aging process, but it can be painful if the disks break down or rupture. If the symptoms are severe, they can affect the spinal cord or nerve roots. Symptoms can range from mild to disabling, and they often begin in the lower back or neck. Typical symptoms are general weakness, pain that is made worse by sitting or certain movements, and numbness or tingling in the arms or legs (called paresthesia).
Diagnosing a herniated disc requires physical examination, imaging tests and sometimes blood work. The most important diagnostic test is magnetic resonance imaging, or MRI, which provides a detailed image of the discs and how they are affected by other structures in the spine. Other diagnostic tests include x-rays, computed tomography, or CT scans, which provide images of the bones in the spine and can help identify bone changes associated with herniated discs.
Nonsurgical treatments for herniated disks focus on relieving pain and preventing further damage. Medication, such as over-the-counter pain relievers like ibuprofen, can be used to ease pain and inflammation. In some cases, doctors will suggest steroid injections to reduce inflammation and pain in the epidural space in the spine or around the nerves. Doctors may also recommend exercise and physical therapy that strengthens the muscles in the neck and back, which can help support the spine.
Spinal stenosis is narrowing of the spinal canal, which puts pressure on the nerves and spinal cord. Symptoms vary depending on which part of the spine is affected. It typically develops slowly over time due to the normal wear-and-tear changes that occur in the spine as we age. It can also be caused by herniated disks, spinal trauma, or a genetic condition such as scoliosis. It is most common in adults over 50 and affects men more than women.
If you have spinal stenosis, it’s important to follow your doctor’s treatment plan. Your doctor will begin by reviewing your medical history and performing a physical examination. They will check your spinal flexibility and the location of the pain. They may perform an MRI or CT scan with dye injected around the spinal cord and nerves to look for narrowing of the space around them.
Steroid injections can help ease pain and numbness from spinal stenosis. They can be administered by a physiatrist or an anesthesiologist. These are usually a temporary measure and are often subject to “waxing and waning” effects, but can help manage your pain and other symptoms until surgery can be scheduled.
Surgery can create more space in the spine and ease the symptoms of spinal stenosis. It involves removing overgrowth of bone or tissue that is pinching the spinal nerves. It’s important to find a surgeon who has experience with this procedure.
During surgery, the surgeon will remove bone spurs and overgrown tissue from the front of the spinal column. They will often remove the portion of the spinal vertebrae called the lamina, which is the arched part that covers the spinal cord and nerves. The facet joints, which are located in the back of the spine, and are directly over the spinal nerves, may also be removed. This helps reduce the pinching from a herniated disc as well.
If spinal stenosis compresses the spinal cord, it can cause problems with your legs and arms (known as radiculopathy), or it can lead to loss of bladder and bowel control (known as cauda equina syndrome). This is a medical emergency and requires immediate attention.
The neck muscles are used a lot and if they become weak and stiff, this can cause pain in the neck. Muscle spasms can also cause neck pain. These are a sudden tightening of one or more of the neck muscles for no apparent reason and may cause neck pain down one side and headaches. They often only last a few hours or days but sometimes for several weeks. They are usually not serious but can be very unpleasant and it’s a good idea to talk to your doctor about them.
As we get older it’s quite normal for the bones, joints and discs of our back to become a little stiffer. It’s also common to have some muscle pain in the neck or shoulder area as we age. This is because of the way the neck muscles are used and it’s not necessarily a sign that there is a serious problem.
Poor sitting or working postures can also cause neck pain, especially if you have to crane your head to look at computer screens for long periods. Tight neck muscles from stress or anxiety can also cause pain and stiffness. Some people find that applying a hot or cold pack helps to ease pain and stiffness. This can be a heat pad bought in chemists or sports shops, a microwavable wheat bag, a hot shower or bath, or an ice pack from a freezer. It is useful to alternate between hot and cold packs throughout the day and night to help ease the pain and stiffness.
Neck pain is less likely to be a serious problem than lower back pain, but it can still have a big impact on your quality of life. Most neck problems can be helped by physiotherapy and by taking over-the-counter painkillers. It is important not to allow the neck pain to stop you doing your normal activities, particularly if it’s been going on for more than three months.
Your doctor will take a careful history and perform a physical examination to decide what is causing your neck pain. You might need x-rays, a blood test or an MRI scan but these aren’t always necessary.
Everyday movements like standing, sitting, brushing your teeth and walking can cause back pain. Over-the-counter pain relievers and staying active can help reduce back pain.
Rarely, back pain can be a warning sign of a serious health condition. It’s important to check with a doctor if your back pain is severe or lasts more than a few weeks.
Pain is the most common symptom of back problems. It may be felt in the neck (cervical), middle back (thoracic) or lower back (lumbar) area of the spine, and it can vary from a dull ache to a sharp, burning, shooting or stabbing pain. It can also cause numbness in the arms and legs. Pain can be made worse by certain movements, like bending over or sitting up. It’s also often worse when you’re stressed or anxious.
Most back pain isn’t caused by a serious condition and gets better on its own with time. However, some back pain can be caused by a herniated or bulging disc, which is a serious problem that needs to be treated. It’s also possible that a slipped disc can pinch a nerve in your spine, causing pain and other symptoms such as numbness and weakness. These types of problems need to be treated as soon as possible.
There are a number of ways to manage back pain, such as taking over-the-counter pain relief medications or using heat and cold therapy. Some people find it helpful to do specific exercises or activities to help relieve the pain. Other people find psychological treatments such as cognitive behaviour therapy (CBT) helpful for managing back pain.
If you have back pain, it’s important to see your health care professional if it is affecting your daily life or work. You should also see a doctor if the pain is severe and lasts for more than two weeks.
When you see your doctor, they will ask questions about the onset of the pain. They will also ask about any other symptoms you’re experiencing, such as bowel or bladder control problems and leg weakness. Your doctor will also do a physical exam and look at your posture to assess the condition of your back. They might also take x-rays to check the bones of your spine for any abnormalities. They may also refer you to a specialist for further tests or treatment if they think it’s necessary. This may include a CT scan or an MRI scan to get a clearer picture of what’s causing your pain.
There are a range of structures in the back that work together to support your body and help you move. They include the spine – the bones in the middle of the back (vertebrae), intervertebral discs – cushion-like pads between the vertebrae that act like shock absorbers and spacers, ligaments – short bands of tough tissue that connect muscles to bone, and muscles – bundles of dynamic tissue that support your back and upper body. Problems with any of these can cause stiffness.
Stiffness can range from a dull ache to a sharp pain that makes it hard to stand up or bend over. It can come on suddenly or build up gradually over a few weeks or months. It may be a constant ache or it might come and go. It might be felt in one area of the back or across the whole back, or it might be felt more in your arms and legs.
Most back pain gets better on its own, especially if you are careful with lifting and moving around. Simple painkillers such as paracetamol can be helpful. Over-the-counter nonsteroidal anti-inflammatory medicines, such as ibuprofen, may also ease discomfort. If pain is severe or persists, your doctor may prescribe stronger NSAIDs or codeine-based narcotics.
Some people are more prone to back problems than others. Age, particularly after the age of 30, can make you more likely to have back pain. It’s common for the spinal discs to wear out or become less flexible with age, and this can lead to back pain. Being overweight or having a sedentary lifestyle can put more stress on your back. Certain diseases, such as rheumatoid arthritis and cancer, can also lead to back pain.
If over-the-counter treatments don’t relieve your back pain, your doctor will probably refer you to a specialist clinic for further investigation. Magnetic resonance imaging (MRI) or computerised tomography (CT) scans may be used, although X-rays aren’t usually useful for back pain. This is because they only show changes in the bones of the spine, and soft tissues such as ligaments and muscles don’t appear on X-rays.
Many people rely on a good night’s sleep to get through the day. Back pain, however, can interfere with sleep. Almost eight out of 10 people will experience back pain at some point in their lives, and it can range from mild to severe. Sleep disturbances can also exacerbate the symptoms of back pain, so focusing on sleep health is important.
The underlying problem with insomnia associated with back pain is that the discomfort and pain prevent the body from entering the optimal sleep cycle, which is essential for restorative healing. This vicious cycle is often difficult to break, but there are several things that can be done to promote a better sleep pattern and relieve back pain at the same time.
For example, if you have trouble sleeping due to back pain, try reducing your intake of chemicals such as caffeine and nicotine in the hours before bedtime. These substances can interfere with the sleep cycle and cause you to wake up too early in the morning. If you need to take prescription sleep medications, talk to your doctor about the best way to use them so that they do not affect your ability to fall and stay asleep.
A few other lifestyle adjustments can help. Try getting at least 30 minutes of quality exercise each day to wear down the muscles and joints and allow the body to enter a restorative sleep pattern. You can do a variety of exercises, such as walking, swimming or yoga. If you are a heavy smoker, quitting the habit may improve your sleep as well as reduce the risk of developing back problems.
Back pain is one of the most common medical conditions that causes insomnia. It can be caused by an injury, chronic back issues or a number of other underlying factors. Researchers have found a relationship between back pain and insomnia, but the exact nature of this connection is still unclear. Some studies have indicated that back pain leads to insomnia, while others suggest that insomnia leads to back pain. Regardless of the direction of causality, both back pain and insomnia have serious negative effects on overall quality of life.
Back pain can vary from a dull ache to stabbing and shooting pain that may spread into the buttocks and legs. It can come on suddenly, often after a fall or lifting heavy weight, or it can develop gradually and last for months or even years. Back pain can also be a sign of serious medical problems, such as bowel or bladder control issues or a kidney or bladder infection. If your back or neck pain comes on suddenly and severely limits your movement, consult a health care professional.
Most people can manage their back pain with simple home remedies, such as taking painkillers and using a heat or cold compress. Your doctor can advise you on a stretching programme that will help your back to heal, as well as exercise that can improve strength and flexibility. Manual therapy techniques such as manipulation and mobilisation, performed by chiropractors or physiotherapists, can be very helpful for some patients.
Some people with back pain will need further treatment, such as injections to the area that contain a steroid. Alternatively, a specialist procedure called nerve root block can be used to target irritated nerves. If your back pain is long-lasting and interferes with your daily activities, surgery may be an option. This could involve removing a herniated disc, widening the space around the spinal cord or fusing two spinal vertebrae together.
The most common way to get rid of back pain is to rest for a few days and then start moving again. But it’s important not to stay in bed for too long, because this can lead to loss of muscle tone and flexibility, as well as making the pain worse.
Most back pain goes away on its own within a month. But if yours doesn’t, you can see a specialist.
The doctor might order X-rays or CT scans to look for arthritis or broken bones. But these images won’t show herniated disks, which can cause back pain.
Physical therapy might include applying heat or ice and muscle-release techniques to the back muscles and soft tissues. It might also involve flexibility and strength exercises and posture-improvement techniques.
Painkillers are a good start, especially those with anti-inflammatory properties. Taking them regularly as directed can help reduce swelling and inflammation, and allow you to continue with your normal activities. Non-steroidal anti-inflammatory drugs (NSAIDs) such as paracetamol and ibuprofen, available from pharmacies and supermarkets, are effective for most back pain. These can be combined with heat or cold treatments to relieve the pain and to encourage blood flow to the area, which will help to speed up healing.
If your back pain persists and you have other symptoms, such as numbness or weakness in the legs, it is important to see a doctor. These may be warning signs of a serious problem, such as an infection or bone fracture. You should also contact your doctor if your back pain is very severe and/or gets worse over several weeks.
Many people with back problems are told to rest, but this doesn’t always help and can actually make the pain worse. Staying active is more beneficial for the back as it keeps the muscles strong, and helps to distribute weight evenly. It is also a better idea than staying in bed as this can make the back stiff and weak, leading to further problems.
Physiotherapy is another useful treatment for back problems, as are ‘hands-on’ treatments such as manipulation of the spine and surrounding tissues. These treatments are often carried out by osteopaths and chiropractors, but can be offered by physiotherapists as well. It is also possible to have injections into the spine, which can ease pain in some patients with lumbar spinal stenosis or sciatica. This type of injection is called radiofrequency denervation and works by heating up the small joints in the spine, which eases the pain.
Exercise is one of the most effective treatments for back pain and has been found to help people recover faster. This is because the muscles around the spine get stronger with regular activity, providing more support for the bones and joints and taking pressure off them. Exercise can also help to relieve stiffness and improve your range of movement. If you are having pain in your back that is preventing you from doing the exercises you enjoy, then speak to your doctor or physiotherapist about how you can gradually increase your exercise level.
The most common causes of back pain are muscle strains or sprains, which can happen when you lift something heavy, twist your back or bend over. The pain may be sharp or dull and aching. You may also feel a tight feeling or hear a snapping sound. Sometimes the pain will travel down your legs. This is called sciatica and is usually caused by a nerve in the spine being pressed on or squeezed.
Other causes of back pain include a change in the shape of your spine (scoliosis) or arthritis of the spine and hips. In some cases, the pain is caused by a stress fracture in your sacrum (the large bone at the base of your spine). These are difficult to diagnose because standard X-rays and other scans do not show them.
The best way to prevent back pain is to keep fit, eat well and maintain a healthy weight. Doing core exercises – like pelvic tilts and bridges – can strengthen the muscles in your abdomen and back that support the spine. It is also important to avoid sitting for long periods and to move around and change positions frequently.
Back pain is usually caused by a mechanical problem, but sometimes it can be linked to a serious disease. It’s important that you see a doctor early on, so they can check that it’s not something more serious. The doctor can assess how much movement you can do before the pain stops you and may want to carry out some further tests to find the cause of the pain. These might include X-rays, MRI or CT scans (these generate images of the bones, muscles, ligaments and discs in your body) blood tests and nerve studies using electromyography (EMG).
Physiotherapy is used to treat muscle and spinal injuries or problems. It’s an important part of treatment for most people with back pain and can help you to get better faster. The treatment might include exercises to strengthen the muscles in your back, and techniques like acupuncture or massage.
Sometimes the doctors might prescribe anti-inflammatory or numbing injections in your back, which can help reduce the pain and swelling. They might also prescribe drugs that affect how your nervous system processes pain. These are called neuromodulatory agents.
Rarely, you might need surgery for back problems. This might involve removing small disc fragments that have broken off or disintegrated. Sometimes doctors might remove the bone that makes up the coccyx (a small bone at the base of the spine). They might also operate to take pressure off the nerves passing through the spine, which is known as spinal stenosis.
Talking therapies can be useful in treating back problems. Cognitive behaviour therapy (CBT) is a type of talking therapy that can help you change how you think and behave. It can help you manage your problems and feelings, such as depression or anxiety.
Massage is a technique that manipulates the muscles and soft tissue of the body. It encourages blood flow and increases the amount of oxygen and nutrients that reach your muscles, joints and tissues. It can also help remove waste products, such as carbon dioxide and toxins, from the body. The type of massage you have will depend on your individual needs, and can include:
Deep tissue massage — this gets into tight muscle and tendons to release knots (also called trigger points) which cause pain. Remedial massage — this helps heal injured or painful muscles, tendons and ligaments by stimulating the body’s natural healing processes. Sports massage — this reduces the strain on muscles and tendons and helps improve flexibility in athletes and reduce back pain.
Warm packs or hot showers can ease back pain and stiffness by easing the tension in the muscles. Putting an ice pack on the area for 20 minutes a few times a day, bought from a chemist or sports shop, or a bag of frozen peas, can also ease inflammation.
It’s best to have a massage when you have plenty of time to rest afterwards. After some massages you might feel a little achey or so relaxed that you get drowsy; it’s worth planning your day carefully so you have time to recover.
The spine, also known as the backbone, is one of the strongest parts of the body. It consists of 24 bones, called vertebrae, sitting one on top of each other with discs in between and lots of strong ligaments to hold them all together. There is a small space in the centre of the spine, through which runs the spinal cord, connecting to the brain and the rest of the body. There are many things that can cause back pain, such as spondylolisthesis (a slippage of one vertebrae on another), osteoarthritis and herniated discs. Back pain can also be caused by the degeneration of the cartilage that cushions the bones of the joints and the development of bone spurs. Other causes include fibromyalgia and osteoporosis (a gradual decrease in bone density).
The vast majority of back pain can be treated without surgery, but there are times when it may be necessary. For example, if back pain is very severe or is causing loss of control of bladder and bowel or nerve function, then urgent surgery may be needed.
It is important to remember that back pain can also be a symptom of other serious problems in the body, such as an abdominal aneurysm (enlarged artery in the belly), tubal pregnancy, kidney stones and pancreatitis. These conditions will also cause pain in the lower back and can be mistaken for a spinal problem. Clues to these problems include a pain that waxes and wanes, with frequent peaks of intense pain; weight loss; and trace amounts of blood in the urine.
In most cases, a specialist will examine your back to decide whether you need further tests or treatment. Over-the-counter pain relievers may be enough, but if the pain isn’t getting better, your doctor might refer you to a physiotherapist for early treatment that can help ease the pain and speed up your recovery.
Back pain is a common problem for many people. It can be caused by problems with the spine, discs or muscles. It may also be due to inflammatory conditions or other medical problems.
It is sometimes difficult to accurately communicate the location and severity of back pain to your doctor. This is because referred pain often originates elsewhere in the body and travels down a nerve to the low back.
Spinal stenosis occurs when the spinal canal gets smaller, making it harder to pass nerves through. It’s most common in the lower back (lumbar spine) and gets worse with age. It can also happen with injury, herniated disks or tumors. Symptoms include pain, tightness or weakness that goes up and down with movement. They may be worse after sitting or leaning forward, and relieved by walking, reclining, resting or taking medication.
The spine is a column of bones that runs up the center of your body. It helps you stay upright, but it also flexes to let you bend and twist. Between each bone are spongy disks that cushion them so they don’t rub against each other. As we age, those disks dry out and thicken, and this can lead to a spinal stenosis, in which the spaces shrink and press on nerves.
X-rays can show the shape and alignment of your spine and outline the joints. X-rays can also show aging-related changes in your spine, like loss of disk height and bone spurs. A computed tomography scan (CT) or a magnetic resonance imaging (MRI) can create better images of your spine, including the spinal cord, disks and nerves. CT and MRI both use a combination of X-rays and computer technology to create cross-sectional images. A CT myelogram adds a dye that shows the spinal cord and nerves.
Treatment options for lumbar spinal stenosis include painkillers, physical therapy and, in some cases, injections. If those treatments don’t work, your doctor might recommend surgery. Surgery can involve removing portions of the spine, bones or bony growths that are crowding the spinal canal and pinching spinal nerves. Doctors might also remove a herniated disk or one or more facet joints during a laminectomy.
Talk to your neurosurgeon for more information about your specific situation and the risks of spinal stenosis surgery. You can find a neurosurgeon in your area by visiting the American Association of Neurological Surgeons’ website at Find a Neurosurgeon. You should also talk with your doctor about whether the potential benefits of surgery outweigh the risks and discomfort associated with it.
The bones of your spine (vertebrae) are cushioned by intervertebral discs that act as shock absorbers. The disks have a tough outer wall called the annulus that crisscrosses like a tire tread and an inner gel-like center called the nucleus. Over time and as we age, the spongy center of the disk dehydrates or shrinks, leading to a loss of cushioning between vertebrae. This can put abnormal stress on the surrounding vertebrae, which causes damage and pain. This condition is called lumbar disc disease or DDD. It is a major cause of low back pain, particularly in the lower (lumbar) spine.
Symptoms include pain when sitting, bending or twisting. You may also feel numbness or weakness in your legs and feet. Your doctor will ask you about your symptoms and when they started. He or she will also examine your back. The doctor will use a stethoscope to hear the sound of your spine as you move. The doctor will also tap on your back and feel for a response to pressure, which can indicate a compressed nerve root.
A bulging or ruptured disk can occur when the nucleus breaks through the outer annulus and presses on nerve roots that travel through the lumbar spinal canal. Usually this happens between the fourth and fifth lumbar vertebrae or the fifth lumbar vertebrae and the first sacral vertebrae (L4-5 and L5-S1 levels). Most herniated disks happen in the lower lumbar spine.
Surgery can help if your pain doesn’t respond to nonsurgical treatments. A neurosurgeon can remove part of a damaged disk or the entire disk, which takes pressure off the nerves. Alternatively, your doctor can make the spine more stable by using a procedure called fusion. In a fusion operation, the doctor joins the bones of your spine together permanently.
While most back pain isn’t preventable, you can lower your risk of sciatica by avoiding prolonged periods of sitting or standing with pressure on your buttocks. Regular exercise and good posture can help, too. The American Academy of Physical Medicine and Rehabilitation (AAPM&R) has a number of articles about preventing and treating sciatic nerve-related problems, including herniated discs and spinal stenosis. Its OrthoInfo site includes a tool to find a physician who specializes in injuries and diseases of the musculoskeletal system (which includes your spine).
Sciatica is any pain, numbness or weakness that follows a path from your low back down the back of your buttock and the back of your leg and foot. The pain may be sharp, burning or achy. It usually affects only one side of your body.
Most often, it’s caused by a herniated, bulging or ruptured disc that presses on nearby nerves. It can also be caused by narrowing of the nerve tunnel through your lower spine, called lumbar spinal stenosis. Or it can be caused by bone spurs around your vertebrae or general wear-and-tear on the bones of your lower spine as you age.
Your doctor diagnoses sciatica by taking a full patient history and performing a physical exam. They’ll ask you where the pain is, what it feels like and whether it gets worse when you sit for long periods or cough or sneeze. They may also order imaging tests to find the cause of your sciatica. These include spinal X-rays, magnetic resonance imaging (MRI) and computed tomography (CT). In some cases, your doctor may inject a dye into the space surrounding the spinal cord or nerves for clearer images.
Sciatica can take weeks or months to get better, especially if you wait too long to see a healthcare professional. You can help reduce your risk of sciatica by keeping your weight under control and following good posture techniques while you’re sitting, standing, lifting objects and sleeping. You can also strengthen your back and abdominal muscles to support your spine.
When you have back pain, it can be challenging to know what to do. It can feel like everything you do could hurt. From walking and breathing to brushing your teeth, even laughing can cause a flare-up of pain. It’s important to remember that you don’t have to live like this.
Whether you are experiencing back pain because of a herniated or degenerative disc, a spinal bone fracture, or something else, there is help available. There are a number of options that can help reduce your pain and return you to the activities you love.
One of the most common causes of back pain is a spinal nerve compression, or neurogenic claudication. This condition is closely related to lumbar spinal stenosis (LSS). Spinal nerves run inside the spaces that are formed by vertebrae and discs on the front side, and by ligaments that connect the spine bones to each other on the back side. When the space that these nerves run through narrows due to LSS, it can compress them causing pain in the lower back and legs. The symptoms are characterized by a feeling of numbness and weakness in the buttocks and legs that can get progressively worse. It is often difficult to walk long distances because of the pain. Neurogenic claudication differs from vascular claudication, which is a result of insufficient blood flow to the legs when you are active.
While both vascular and neural claudication can occur with LSS, a person’s symptoms will usually be more intense with neural claudication. This is because the spinal nerves in the lumbar region of the spine are affected when the spaces within the spine narrow, and these are responsible for sending messages to the legs.
Neurogenic claudication can be both unilateral (most often with damage to one root, such as a lateral herniation) and bilateral (due to a combination of LSS and central herniations). The symptoms of neurogenic claudication can be relieved by bending forward or sitting down. This is a pathognomonic sign that suggests the presence of spinal stenosis and should prompt additional evaluation methods.