Neurogenic claudication is when nerves in the spinal cord become inflamed, causing pressure and limiting body functions, typically mobility.
Neurogenic claudication is a common side effect of spinal stenosis, when spinal nerves are compressed in the spinal column pathway. The name means that the problem is a result of nerve complications (neurogenic) and it is characterized by a weakness and pain the legs that makes it hard to walk (claudication is Latin for “limp).
The Laser Spine Institute says it is important to differentiate this damage from vascular claudication which is a loss of mobility due to circulatory problems rather than nerve issues.
Locations of Numbness or Pain
Patients experience neurogenic claudication in the foot, calf, thigh, or buttock, and it can present on just one side of the body or on both sides. The most common area to experience symptoms in is the calf.
Many patients report prior issues with standing or walking for long periods of time and that pain is only temporarily relieved by flexing the leg, not by rest, according to the Laser Spine Institute.
If the condition is serious it can also include the feeling of pins and needles in the affected area during general movement or potential restriction of bowel movements and other bladder issues.
Neurogenic claudication is typically caused by compression in the spinal column, which its inflammation can make worse, and is most associated with spinal stenosis. This is a degenerative spinal condition that often occurs as we age.
As people get older, their spines can become constricted, especially around the openings where nerve fibers pass in and out of the spinal column. Constriction puts pressure on nerves and compresses their available space, causing the neurogenic claudication.
Because of its relation to age, it generally takes a long time to develop or for symptoms to appear and often hits the middle aged and elderly. Age-related spinal stenosis is most common in the lumbar and cervical (lower back and neck) regions of the spine because these are flexed and used most often.
Bone spurs, herniated discs, and other spinal abnormalities, such as bulging discs, can also cause neurogenic claudication if they develop to be large enough or are placed in a way that they constrict nerves that move through spinal openings.
Treating Neurogenic Claudication
Initial treatments for neurogenic claudication include pain medications and physical therapy in order to keep the legs and body active and to address the pain experienced. Therapy exercises focus on flexing the spine forward and improving posture to relieve the stress and pressure on these nerves.
Drugs used to treat neurogenic claudication are often over-the-counter or prescribed pain relievers and anti-inflammatory drugs; they tend to be free of steroids in most cases. If a patient has severe pain or physical limitations, doctors may prescribe steroid or opioid pain relievers, but these are strictly controlled.
If the case is more severe or other factors limit mobility, patients may also be prescribed a back brace for everyday use. Some doctors also treat with epidural injections directly into the spine in order to stop severe pain.
Surgery should be viewed as a last resort when it comes to treating this disorder. Decompression surgery still carries significant risks and the treatment and detection of neurogenic claudication and spinal stenosis do not have established methods. This means treatment can vary depending upon your doctor.
Alternative Therapy Treatments
Some treatments of spinal stenosis also help neurogenic claudication, including alternative therapy treatment options. The big three are acupuncture, massages, and Pilates.
Acupuncture is the application of tiny needles to certain areas in the body in order to relieve stress, reduce pain, and increase the flow of energy in the body. It is an old practice and different practitioners may also include the use of incense, varying temperatures and a varying number of needles.
Massage therapy is provided in order to relax the muscles of the back and legs, removing pain and allowing them to better support the spine after a treatment. Muscles that are more relaxed can help relieve pressure on spinal column nerves.
Pilates is a type of muscle-strengthening exercise that focuses on the core and back. It also includes stretching exercises that aid the neck and its support muscles. By strengthening these muscles, the body is better able to support the spine in a proper posture, alleviating some of the stress associated with neurogenic claudication.
There are three main risk factors that patients can do something about in their daily lives, according to the American Medical Association: smoking, weight, and exercise.
While these three areas crop up in most risk-factor lists and are general wellness categories, doctors can point to specific reasons for changing these habits in relation to neurogenic claudication.
It is recommended not to smoke because smoking can reduce the overall nutrients delivered to the spine by depriving blood of oxygen.
Excess body weight puts extra pressure on the neck, back, and spine, so it is recommended that patients maintain a healthy weight and a low body mass index.
Low-impact exercise, such as stretching and yoga, is also recommended to help reduce the risk of neurogenic claudication. Keeping the back and the core muscles flexible and strong will provide your back with additional support. A strong back keeps the spine properly aligned and can help alleviate pressure on spinal nerves.
Addressing these risk factors has the added benefit of also being a prescribed way to reduce the likelihood of developing bone spurs or bulging discs, common causes of spinal stenosis.
The Walking Relief
While it may seem counterintuitive, walking more each day actually helps to reduce the pain associated with neurogenic claudication because it can strengthen muscles and promote better posture.
Elderly individuals who walk for at least 30 minutes each day have reported marked improvements in terms of pain reduction, general weakness, and deferred leg pain or paralysis, according to the National Institutes of Health.
While many consider lower back pain and mobility issues a part of growing older, there are many steps that can be taken to reduce the impact of neurogenic claudication in your daily life.