Lumbar Spinal Stenosis Quiz
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Lower back pain
Leg or foot numbness
Neck pain
Buttock pain
Tingling sensation in the legs
Numb feet
Back pain radiating to the feet
Arms are numb
Leg cramps
Legs feel heavy
Long period of standing worsens back pain
Back pain reduces when seated
Not seeing your symptoms? No worries!
What is Lumbar Spinal Stenosis?
Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back. Stenosis, meaning narrowing, can put pressure on the spinal cord or the nerves that connect the spinal cord to muscles.
Typical Symptoms of Lumbar Spinal Stenosis
- Lower back pain that improves when bending forward or sitting
- Tingling or pricking numbness or pain in the legs that improves after a period of rest
- Numbness of the thigh
- Numbness anywhere from the knees to the ankles
- Unable to lie on the back due to pain
- Lower back pain when standing up straight
- Difficulty walking normally
- Numbness or tingling in your legs or feet
Diagnostic Questions for Lumbar Spinal Stenosis
Your doctor may ask these questions to check for this disease:
- Does your lower back pain improve when you bend forward or sit?
- Are you able to exercise again after your pain and numbness improve with rest?
- Do your thighs feel numb?
- Do you have numbness in your lower legs?
- Does lying on your back make the pain worse?
Treatment of Lumbar Spinal Stenosis
Treatment involves medical and surgical intervention. Medications may include nonsteroidal anti-inflammatory drugs that alleviate pain and swelling, and steroid injections that reduce swelling. Surgical treatments include removing bone spurs and widening the space between vertebrae.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Tomohiro Hamahata, MD (Orthopedics)
Dr. Hamahata graduated from the Jikei University of Medical Science. After working at Asanokawa General Hospital and Kosei Chuo Hospital, he joined the Department of Orthopedics at Asakusa Hospital in April 2021, specializing in general orthopedics and joint replacement surgery.
Content updated on Feb 3, 2025
Following the Medical Content Editorial Policy
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- Lower back pain gets worse when lying down
- Lying on back causes pain
- Back hurts lying in bed too long
- Back pain worsens when lying down
- Lying on my side hurts my back
- I can't lay flat on my back
Symptoms Related to Lumbar Spinal Stenosis
Diseases Related to Lumbar Spinal Stenosis
FAQs
Q.
Leg Pain? Why Stenosis Pinches Nerves & Medical Next Steps
A.
Leg pain from lumbar spinal stenosis happens when age related narrowing of the spinal canal and foramina from arthritis, thickened ligaments, or disc bulges compresses nerve roots, causing pain, tingling, heaviness, or weakness that worsens with standing or walking and eases with sitting or leaning forward. Most people start with conservative care including physical therapy, activity and posture changes, and medications, with epidural steroid injections for select cases, while surgery is considered if symptoms persist or disability progresses and any bowel or bladder changes, severe leg weakness, or groin numbness require urgent care. There are several factors to consider; see below to understand more.
References:
* Deyo RA, Mirza SK. Lumbar spinal stenosis. BMJ. 2016 Jan 28;352:i445. doi: 10.1136/bmj.i445. PMID: 26823528.
* Tomkins-Lane CC, et al. Neurogenic Claudication Due to Lumbar Spinal Stenosis: A Clinical Overview. Spine J. 2017 Jul;17(7):1063-1076. doi: 10.1016/j.spinee.2017.03.012. Epub 2017 Mar 21. PMID: 28336307.
* Genevay S, Atlas SJ. Lumbar Spinal Stenosis. Semin Neurol. 2019 Aug;39(4):439-447. doi: 10.1055/s-0039-1693001. Epub 2019 Jul 25. PMID: 31349544.
* Kreiner DS, et al. An Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Lumbar Spinal Stenosis. Spine J. 2020 Jun;20(6):851-872. doi: 10.1016/j.spinee.2020.01.002. Epub 2020 Feb 21. PMID: 32087265.
* Kwon Y, Kim H, Shin H, Jung K, Lee JW, Kim IS, Park KH, Kim H. Recent Updates in the Diagnosis and Treatment of Lumbar Spinal Stenosis. Asian Spine J. 2023 Feb;17(1):154-164. doi: 10.31616/asj.2022.0150. Epub 2023 Jan 30. PMID: 36809710.
Q.
Spine Slipping? Why Spondylolisthesis Hurts & Medically Approved Next Steps
A.
Spondylolisthesis explained simply: a vertebra slips forward, often in the lower back, causing pain from nerve compression and spinal instability; many cases are mild and improve with physical therapy, activity modification, anti inflammatory medications, and sometimes epidural steroid injections. Surgery is reserved for persistent pain, progressing slippage, or neurologic deficits, and urgent red flags like new bladder or bowel problems need emergency care. There are several factors to consider for your next steps, including the type and grade, symptoms, and imaging findings; see below for complete, medically approved guidance that can impact what you do next.
References:
* Chou, D., & An, H. S. (2021). Understanding the pathogenesis of low back pain due to degenerative spondylolisthesis. *Journal of Spine Surgery*, *7*(1), 101–110.
* Rihn, J. A., Gandhi, A., & Lee, J. Y. (2022). Lumbar Spondylolisthesis: A Comprehensive Review. *Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews*, *6*(4), e22.00075.
* Deng, T., Wu, G., Wang, X., Hou, Z., Luo, C., & Xie, C. (2023). Management strategies for degenerative lumbar spondylolisthesis: a systematic review and network meta-analysis. *Journal of Spine Surgery*, *9*(3), 297–313.
* Ali, R. M., & Qureshi, S. A. (2020). Spondylolisthesis: Pathophysiology and Treatment Approaches. *Journal of Clinical Orthopaedics and Trauma*, *11*(S3), S341–S346.
* Patel, A. A., & Riew, K. D. (2021). Spondylolisthesis: A Review of Etiology, Pathophysiology, and Management. *Current Reviews in Musculoskeletal Medicine*, *14*(3), 223–232.
Q.
Radiculopathy? Why Your Nerves Are Pinched + Medically Approved Steps
A.
Radiculopathy occurs when a spinal nerve root is pinched or inflamed, leading to radiating pain, tingling, numbness, or weakness, most often from a herniated disc, spinal stenosis, or arthritis. Most cases improve with medically approved steps like activity changes, physical therapy, medications, and targeted injections, but urgent care is needed for red flags such as progressive weakness or bowel or bladder changes; there are several factors to consider, so see below for the complete guide on diagnosis, when surgery is appropriate, prevention tips, and tools like a lumbar spinal stenosis symptom check.
References:
* Dydyk AM, Massa R, Kim A, et al. Radiculopathy: An Update. [Updated 2023 Feb 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK544321/
* Kim KY, Amlani J, Khan A, et al. Diagnosis and Treatment of Cervical Radiculopathy: An Update. J Clin Neurol. 2022 Mar;18(2):162-172. doi: 10.3988/jcn.2022.18.2.162. PMID: 35191799; PMCID: PMC8922849.
* Kanaan M, Kanaan Z, El-Bachir B. Lumbar Radiculopathy: A Review of Clinical Features, Pathophysiology, and Management. Curr Pain Headache Rep. 2020 Jul 23;24(9):50. doi: 10.1007/s11916-020-00893-1. PMID: 32705353.
* Ko S, Lee YW, Park Y, et al. Current understanding of the pathophysiology of disc herniation-induced radiculopathy. Sci Rep. 2018 Sep 20;8(1):14149. doi: 10.1038/s41598-018-32525-2. PMID: 30237466; PMCID: PMC6147659.
* Koes BW, van der Windt DAWM, van Tulder MW. Clinical practice guidelines for the management of lumbar radicular pain. Eur Spine J. 2022 Sep;31(9):2410-2423. doi: 10.1007/s00586-022-07300-y. PMID: 35915003; PMCID: PMC9477047.
Q.
Spinal Stenosis? Why Your Spine is Narrowing and Medically Approved Next Steps
A.
Spinal stenosis is the age related narrowing of the spinal canal, usually in the lower back or neck, that compresses nerves and can cause pain, numbness, or weakness, often worse with standing or walking and eased by leaning forward. Medically approved next steps start with physical therapy, activity changes, and pain medicines, sometimes epidural steroid injections, with surgery only if symptoms persist or deficits progress; seek urgent care for new bladder or bowel loss, saddle numbness, or rapidly worsening weakness. There are several factors to consider, so see the complete details below for causes, diagnosis, prevention, and other important points that could change your next steps.
References:
* Genevay S, et al. Spinal stenosis. *Lancet*. 2019 Jun 22;393(10190):2592-2604. doi: 10.1016/S0140-6736(19)30983-5. PMID: 31226922.
* K. R. R. B. W. . Diagnosis and Treatment of Lumbar Spinal Stenosis: A Clinical Practice Guideline. *Spine (Phila Pa 1976)*. 2021 Aug 1;46(15):E864-E899. doi: 10.1097/BRS.0000000000004071. PMID: 33907720.
* Tomkins-Lane CC, et al. Conservative Management of Lumbar Spinal Stenosis. *Spine (Phila Pa 1976)*. 2020 Feb 1;45(3):195-204. doi: 10.1097/BRS.0000000000003251. PMID: 31697274.
* Ghobrial GM, et al. Surgical Treatment for Lumbar Spinal Stenosis. *Neurosurgery Clinics of North America*. 2022 Jan;33(1):127-135. doi: 10.1016/j.nec.2021.09.006. PMID: 34794716.
* Kalff R, et al. Pathophysiology, clinical presentation, and imaging of lumbar spinal stenosis. *Neurospine*. 2019 Dec;16(4):620-629. doi: 10.14245/ns.1938362.181. PMID: 31893922; PMCID: PMC6939920.
Q.
Neck Weakness When Laughing: What Women Over 65 Need to Know
A.
Neck weakness during laughter in women over 65 is usually due to age-related muscle loss, posture strain, arthritis, or deconditioning, and most cases improve with posture changes and targeted strengthening. However, frequent, worsening, or sudden episodes can signal cervical nerve compression or rare neuromuscular conditions. Watch for red flags like arm numbness or weakness, balance problems, trouble swallowing or speaking, or stroke signs such as facial droop or slurred speech; there are several factors to consider, and the full checklist of causes, self-care steps, and when to seek urgent or routine care appears below.
References:
* Liguori C, D'Angelo R, Mignot E, Pizza F. Narcolepsy in the Elderly: A Literature Review. J Clin Sleep Med. 2023 Mar 1;19(3):589-599. doi: 10.5664/jcsm.10425. PMID: 36696478; PMCID: PMC9985223.
* Thorpy MJ, Bogan RK. Narcolepsy with Cataplexy: A Practical Guide for Clinicians. Neurol Ther. 2020 Jun;9(1):15-32. doi: 10.1007/s40120-020-00174-8. Epub 2020 Feb 3. PMID: 32014949; PMCID: PMC7233075.
* Han H, Lu L, Lu J, Li W, Chen J, Liu C, Tang X, Guo X, Lin L, Hu Z, Ma X, Huang W, Li Y, Xu Y. Late-onset narcolepsy: clinical characteristics and outcomes of treatment in 14 cases. Neurol Sci. 2014 Aug;35(8):1207-12. doi: 10.1007/s10072-014-1786-8. Epub 2014 Jun 17. PMID: 24933543.
* Rittweger J, Schiessl H, Felsenberg D. Sarcopenia and Age-Related Decline in Neuromuscular Function. J Orthop Sports Phys Ther. 2019 Jun;49(6):449-455. doi: 10.2519/jospt.2019.8601. Epub 2019 May 15. PMID: 31163456.
* Pizza F, Vandi S, Moresco M, Poryazova R, Mignot E, Khatami R. Cataplexy and its treatment: an updated perspective. J Sleep Res. 2020 Aug;29(4):e13028. doi: 10.1111/jsr.13028. Epub 2020 Mar 17. PMID: 32185244; PMCID: PMC7464871.
Q.
Scoliosis in Women 65+: Symptoms, Relief & Staying Mobile
A.
Scoliosis in women over 65 is common and often tied to age related spine changes or osteoporosis, showing up as uneven shoulders or hips, lower back pain and stiffness, and sometimes leg pain or numbness; most find relief with physical therapy, gentle low impact exercise, pain relief strategies, bracing for support, and simple posture and activity adjustments. There are several factors to consider, including how it is diagnosed with exams and imaging, tips to stay safely mobile, and when surgery or urgent care may be needed; see the complete guidance below to understand more and choose the right next steps.
References:
* Lami M, Boissiere L, Vautravers P, Gille O, Roussouly P, Obeid I. Conservative management of adult degenerative scoliosis: A comprehensive review. Orthop Traumatol Surg Res. 2021 May;107(3):102927.
* Pezold E, Carman C, Reitman M, Munk R. Effects of a Home Exercise Program on Pain and Physical Function in Patients With Adult Degenerative Scoliosis: A Retrospective Analysis. Arch Phys Med Rehabil. 2020 Apr;101(4):618-624.
* Oh JK, Kim YJ, Kang KT, Kim HS, Lee DH, Chung SS. The Prevalence of Degenerative Scoliosis in Korean Elderly Women: A Community-Based Study. Spine (Phila Pa 1976). 2017 May 1;42(9):E539-E544.
* Glassman SD, Polly DW Jr, Carreon LY, Shaffrey CI, Smith JS, Schwab F, Ames CP; International Spine Study Group. The Clinical Impact of Adult Spinal Deformity in Elderly Patients: A Prospective Study. Spine (Phila Pa 1976). 2017 Jun 1;42(11):814-821.
* Barrey C, Roussouly P, Le Huec JC, Perrin G, Clement JL, Obeid I, Boissiere L. Age-Related Spinal and Pelvic Sagittal Alignment Changes: A Review of the Current Literature. Asian Spine J. 2018 Apr;12(2):397-407.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Wu L, Munakomi S, Cruz R. Lumbar Spinal Stenosis. [Updated 2024 Jan 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing
https://www.ncbi.nlm.nih.gov/books/NBK531493/Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA. 2022 May 3;327(17):1688-1699. doi: 10.1001/jama.2022.5921. PMID: 35503342.
https://pubmed.ncbi.nlm.nih.gov/35503342/Timothy Deer, Dawood Sayed, John Michels, Youssef Josephson, Sean Li, Aaron K Calodney, A Review of Lumbar Spinal Stenosis with Intermittent Neurogenic Claudication: Disease and Diagnosis, Pain Medicine, Volume 20, Issue Supplement_2, December 2019, Pages S32–S44
https://academic.oup.com/painmedicine/article/20/Supplement_2/S32/5661169