Posted By Alex Symington D.C / 6th March 2013
So after a long abscence the Camden Chiropractic blog is back! With a new and improved website that is easier to use and get information about the clinic and Chiropractic. www.camdenchiropractic.co.uk
This week I have had a number of interesting patients in and two cases with the same issue and unusual symptoms of Neurogenic claudication causing leg and back pain. This caused them both leg pain while walking and also in one case severe back pain.
Neurogenic claudication is the medical term to describe the symptom of pain that comes on while walking. This pain can often be dispersed over a variety of poorly defined areas in the lower back and legs. In the instance of one patient the pain experienced was in the lower back with the sensation of ‘heavy legs’ while walking.
Neurogenic claudication is caused by damage to the nerves, namely the spinal cord and the nerves that exit at each level known as the nerve roots. The pressure on the nerves is caused by narrowing of the spinal canal called spinal stenosis, this in turn can be caused by a number of different factors, osteoarthritis (wear and tear) on the spine can cause pressure on the nerve or even a slipped disc (disc protrusion) that pushes on the nerves. Some people have a narrow spinal canal which can leave them more prone to these issues. Commonly patients with these problems are over 60 years old and can be caused by ageing where the ligaments of the spine can calcify and thicken with age as well as the bones and joints.
Commonly in patients with neurogenic claudication, leg pain while walking will occur but if they bend forwards from the lower back this eases their pain. This is due to some of the pressure on the nerves being eased in this position. Sitting can also ease the pain as again this stretches the spine opening up the spaces between the vertebrae. There are two types of claudication, neurogenic with nerve compression and vascular, where narrowing of the arteries causes a reduced blood flow. I won’t go into too much anatomical detail of vascular claudication as that is a subject on its own, however a bike test is the test that would distinguish between the two causes.
A physical examination, full case history and possible further tests that may include an MRI or CT scan or vascular testing may be performed.
Treatment is dependant on the person and symptoms. Initaly treatment is conservative such as Chiropractic care. At Camden Chiropractic this would usually involve relieving muscular tension in the surrounding soft tissue, mobilising the lumbar spine and relieving pressure and inflammation on the lumbar spinal nerves through a variety of mobilisation and manipulative techniques.
If this is ineffective steroid injections or surgery may be the next step, however we do all we can at Camden Chiropractic to prevent the need for this.
If you think you may have symptoms of claudication or any back related issues, please don’t hesitate to contact Camden Chiropractic, Camden Town, London on 07592 399 551.