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11 Cards in this Set
- Front
- Back
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How does back pain from lumbar spinal stenosis present? |
it's pain that worsens with extension and improves with flexion, is posture dependent |
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why does this happen? |
becuase spinal extension further narrows the canal |
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another thing you can see is NEUROGENIC CLAUDICATION |
the patient may have worse back and leg pain with wakling but it's not as highly associated with exertion vs. rest
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Is the pain worse when walking downhill or uphill? |
downhill- forces the back more into extension
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another PE finding that will tell you it's not pain due to intermittent claudication? |
the dorsalis pedis pulse is normal
ABIs are normal |
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what type of activity will help the pain with spinal stenosis? |
cycling or anything else where the patient can spend time leaning forward |
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best dx test for spinal stenosis |
MRI is the only test |
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mgmt of spinal stenosis |
starts with weight loss and NSAIDs/aspirin for pain mgmt
sometimes opioids |
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secondline is... |
epidural steroid injections- these help about 25 to 50% of cases |
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to help delay surgery, what types of exercise can improve spinal stenosis? |
cycling, swimming |
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What % of patients eventualy require surgical dilation of the canal? |
about 75% |
