RRS Education Chiropractic BLOG - Musculoskeletal Research Reviews

Lumbar spinal stenosis is a frequent cause of low back and leg pain, leading to significant disability and functional limitations. I cover this condition in detail in the upcoming program “Older & Bolder: Chiropractic Care for Healthy Aging” - which you can attend in person at one of 8 upcoming events, or enjoy on-demand at home with the upcoming E-Seminar!
The mean prevalence of lumbar spinal stenosis based on clinical and/or radiographical diagnoses vary between 11% and 38% in the general population, with an average patient age of 62. Lumbar spinal stenosis is most commonly a result of degenerative changes causing narrowing of the central spinal canal, lateral recesses, or intervertebral foramen, leading to compression of the neurovascular structures. Neurogenic claudication is characterized by unilateral or bilateral buttock, thigh or calf symptoms such as achiness, cramping, pain or sensory/balance problems with paresthesia, numbness, and weakness, aggravated by prolonged standing or walking and relieved by sitting, lumbar flexion and lying down.
Clinical classification criteria to identify lumbar spinal stenosis causing neurogenic claudication includes: 1) age over 60 years; 2) positive 30-second extension test (reproduction of symptoms); 3) negative straight leg test; 4) pain in both legs; and 5) leg pain relieved by sitting, leaning forward or flexing the spine
Mild to moderate degenerative lumbar spinal stenosis causing neurogenic claudication tends to have a favorable natural history in approximately 60% of patients, however, 30% of patients are expected to worsen. A referral for special investigations and/or surgical consultation is recommended when patients report severe intermittent claudication when walking less than 100 meters, new or progressive lower limb weakness, and failure to respond to an appropriate course of nonsurgical care determined by the patient’s quality of life and expectations.
As a result of the lack of high-quality evidence for the effectiveness of interventions addressed in previous guidelines, new trials are likely to impact subsequent recommendations. Therefore, this guideline aims to provide an updated, evidence-based understanding to inform the nonsurgical management of lumbar spinal stenosis causing neurogenic claudication.
THIS WEEK'S RESEARCH REVIEW: “Non-Surgical Interventions for Lumbar Spinal Stenosis – 2021 Clinical Practice Guideline”
This paper was published in the Journal of Pain (2021) and this Review is posted in Recent Reviews, Lumbar Spinal Stenosis, Clinical Practice Guidelines and the 2022 Archive.
Lumbar spinal stenosis

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