Neurogenic claudication

Condition causing leg pain due to spinal nerve compression

Neurogenic claudication is often associated with spinal stenosis.

Neurogenic claudication is a medical condition characterized by pain and discomfort in the legs due to compression of the spinal nerves, typically caused by spinal stenosis. This condition is most commonly seen in older adults and can significantly impact mobility and quality of life.

Pathophysiology

Neurogenic claudication occurs when the spinal canal narrows, a condition known as spinal stenosis, leading to compression of the cauda equina or the nerve roots. This compression results in reduced blood flow and nerve function, causing symptoms such as pain, tingling, and weakness in the lower extremities. The symptoms are often exacerbated by activities such as walking or standing and are relieved by sitting or bending forward, which increases the space in the spinal canal.

Symptoms

The primary symptom of neurogenic claudication is leg pain that occurs during walking or prolonged standing. Patients may also experience:

• Tingling or numbness in the buttocks, thighs, or calves
• Weakness in the legs
• A feeling of heaviness in the legs
• Relief of symptoms when sitting or leaning forward

Diagram illustrating spinal stenosis, a common cause of neurogenic claudication.

Diagnosis

Diagnosis of neurogenic claudication typically involves a combination of clinical evaluation and imaging studies. A thorough medical history and physical examination are essential to differentiate neurogenic claudication from vascular claudication. Imaging studies such as MRI or CT scan are used to confirm the presence of spinal stenosis and assess the degree of nerve compression.

Treatment

Treatment options for neurogenic claudication aim to relieve symptoms and improve function. These may include:

Conservative Management

• Physical therapy to strengthen the back and leg muscles
• Pain management with medications such as NSAIDs or analgesics
• Activity modification to avoid symptom-provoking activities

Interventional Procedures

• Epidural steroid injections can provide temporary relief by reducing inflammation around the compressed nerves.

Epidural steroid injection for spinal stenosis can help alleviate symptoms of neurogenic claudication.

Surgical Treatment

In cases where conservative and interventional treatments are ineffective, surgical options may be considered. These include:

• Laminectomy to remove part of the vertebra and relieve pressure on the nerves
• Spinal fusion to stabilize the spine

Prognosis

The prognosis for individuals with neurogenic claudication varies. Many patients experience significant improvement with conservative treatment, while others may require surgical intervention to achieve relief. Early diagnosis and appropriate management are crucial for optimal outcomes.

Related pages

• Spinal stenosis
• Cauda equina syndrome
• Laminectomy
• Epidural steroid injection