Neurogenic claudication is caused by Lumbar Spinal Stenosis. The spinal cord or spinal nerves become severely compressed, or squeezed, and they stop working. Patients cannot walk, stand in one place, and are forced to assume a flexed forward posture. They can only walk a short distance before having to sit down. It is often referred to “angina of the spine”.
Neurogenic claudication can also cause weakness, muscle atrophy, balance problems, falls, and in severe cases interfere with bowel and bladder function. It is progressive and does not go away. Once symptomatic, the condition usually gets worse over time.
Treatment involves correcting the underlying condition causing the stenosis. It is very treatable if caught early.
Vascular claudication is a similar condition that can cause the same symptoms. It is caused by poor circulation to the legs (peripheral vascular disease). A simple ultrasound circulation test can differentiate between the two. Of course, some patients may have both neurogenic and vascular claudication.
Neuropathy, a disease of peripheral nerves and nerve endings, can also cause similar symptoms. There are many different types of neuropathies including diabetic peripheral neuropathy. They can affect the sensory and the motor nerves in our legs.
An EMG/Nerve Conduction Study can help determine if a neuropathy is present. Neuropathies cannot be treated with surgery.
Learn about Neurogenic claudication treatment options.
Patients with neurogenic claudication are best treated with spinal decompression surgery. By taking the pressure off the spinal cord or spinal nerves, the blood flow is re-established and the symptoms improve almost immediately.
A major government study recently showed that surgery for the treatment of symptomatic spinal stenosis gave the best short and long term results. Offering conservative non-surgical care is reasonable if the symptoms are not severe.
However, if nerve or spinal cord damage is developing, or has developed, surgery may be too late. This condition needs to be followed closely by the treating physician. Surgery needs to be considered and recommended if non-surgical care is failing.