Neurogenic means arising from the nervous system, and claudication means leg pain. Someone with neurogenic claudication may feel pain, weakness, numbness, or heaviness in the lower extremities, such as the legs, hips, lower back, and glutes. This condition occurs when the nerves in the lower, or lumbar, region of the spine are compressed. And the pain is typically relieved when you bend your spine forward in an action like leaning on a shopping cart (often called the “shopping cart sign”).
Neurogenic claudication is usually caused by spinal stenosis, which is the narrowing of the space in the spine. Spinal stenosis is most commonly found in the five vertebrae that make up the lumbar region of your back. When spinal stenosis occurs in the lumbar region of the back, it puts pressure on the spinal cord and nerves that affect your legs, hips, and feet.
Spinal stenosis is most commonly found in people over the age of 50. Like everything else in your body, general wear and tear occur in your spine as you use your body throughout your life. Changes in the spine due to osteoarthritis can also speed up the wear and tear process. That process causes the spine to narrow, leading to possible neurogenic claudication.
Other causes of this condition included herniated disks and bone spurs in the lower back. A herniated disk occurs when there is a problem with one of the cushions that sit between the vertebrae in your spine. These cushions are called disks.
If a disk slips out of place, it can put pressure on a spinal nerve, causing neurogenic claudication. Similar to spinal stenosis, herniated disks are caused by general wear and tear as you age.
Bone spurs that form on the spine can also pinch or put pressure on spinal nerves. Bone spurs form when the cartilage that protects your bones wears away, causing chronic inflammation. As your body attempts to repair the damage, extra bone growth appears in the form of a bone spur. Inflammation and worn-out cartilage can be caused by injuries or age.
The best way to prevent neurogenic claudication is to live a lifestyle that supports good spinal health. Keeping your spine healthy can lower your risk of developing bone spurs or a herniated disk.
Everyone will experience some amount of spinal stenosis due to the natural narrowing of the spine that occurs over the years. However, through living a healthy lifestyle, some people are able to delay the narrowing of the spine, and many are able to avoid most symptoms, including neurogenic claudication.
Strength and flexibility are both important for spinal health. Your abdominal muscles support your spine, so it’s especially important to keep those strong. Regular stretching and yoga can improve your range of motion in your spine, keeping your spine healthy throughout your life and lowering your risk of spinal conditions.
Carrying around extra weight puts additional stress on your spine, causing it to wear out more quickly. Extra weight can also cause you to have bad form during exercise, which can lead to injuries in your back. Maintaining a healthy weight will help you maintain good spinal health.
Good posture also goes a long way in keeping your spine in good shape. Bad posture while sitting, standing, lifting heavy objects, and performing daily tasks causes additional stress on the spine and potential future pain.
A doctor can help you determine the cause of pain in your legs or lower extremities. A physical exam and imaging scans will help the doctor determine if you are experiencing neurogenic claudication and what the cause is.
Treatment will depend on the advancement of the problem. Sometimes neurogenic claudication can be treated through physical therapy and stretching. However, if the cause is advanced spinal stenosis, cortisone injections can also be added to the treatment plan.
A herniated disk will occasionally heal with rest, giving you relief from your symptoms. Pain from bone spurs in the spine may also improve with rest and physical therapy.
If you’re still experiencing pain after physical therapy and other early treatment plans, a doctor may recommend surgery to relieve the pressure on your spinal nerves.
Some surgeries, such as those for a herniated disk, are minor and do not require an overnight stay in the hospital. However, all spinal surgeries will require months of rest and recovery before being able to perform all your usual physical activities.
The best way to manage pain while dealing with neurogenic claudication is to follow your treatment plan and keep your doctor informed when your pain worsens or improves. The exercises and other treatments you work on in physical therapy should give you some pain relief.
Your doctor can also discuss whether or not a medication to soothe your pain would help. Over-the-counter medications like Ibuprofen and Tylenol can reduce pain. Some inflammation and pain-reducing medications require a prescription, so it’s important to discuss your options with your doctor.
If the pain is still bothering you even while you’re following your treatment plan, there are many pain management strategies that can help you find relief. Studies have found meditation to be an effective pain-relieving tool. Through meditation, some people with chronic pain are able to reduce activity in the brain in the areas that process pain.
Any activity that promotes mindfulness, such as journaling and repeating mantras, can lower pain levels. Deep breathing activities can also increase mindfulness and reduce pain.
Hot and cold therapy helps some people find pain relief, and others use massage to manage symptoms.
If you’re experiencing pain in your lower extremities, you don’t have to continue dealing with it. Reach out to a spinal or neurological specialist, like the experts at Dickinson Neurological Surgery, to determine the source of your pain and whether you need treatment for neurogenic claudication. These experts can help you find relief and get back to living the life you want.