New Standards for the Diagnosis of Lumbar Spinal Canal Stenosis

It’s one of the more common spinal problems for people over 55 – lumbar spinal stenosis.

Smaller Than Average Spinal Canal Predisposes to Symptomatic Stenosis

Smaller Than Average Spinal Canal Predisposes to Symptomatic Stenosis

You get low back pain and leg pain that’s worse standing or walking.  You feel better bending forward or sitting down.  And your legs tire prematurely when you walk.

The symptoms of spinal stenosis are commonly caused by narrowing of the spinal canal from gradual spinal joint degeneration.  The nerves of the spinal cord get pinched, causing pain and leaving your leg muscles weakened.

Although spinal stenosis is common, the standards for diagnosing it are controversial.  Some doctors focus on the nature of the pain and the way it behaves.  Others focus on imaging studies such as MRIs that picture the amount of space available for the spinal cord.

The problem is that not everyone with stenosis-like symptoms has canal narrowing that shows up on MRI.  And vice versa – not everyone with spinal canal narrowing has pain, weakness, or other symptoms.

This is the conundrum that the authors of a recent article in the journal Spine tried to clarify.  They wanted to see what the best diagnostic tests for spinal stenosis were.

Here’s what they found:  MRIs are often the most accurate imaging test to show the narrowing of the spinal canal.  But they shouldn’t be used in isolation.  MRIs are most meaningful when they’re correlated with specific physical signs.  The most significant physical findings include

  • Radiating leg pain that is exacerbated while standing up
  • The absence of pain when seated
  • The improvement of symptoms when bending forward, and
  • A wide-based gait


Deepen Your Body of Knowledge

What causes spinal stenosis and what you can do about it

Lower back pain when standing

Spondylolisthesis – another cause of stenosis


About Ronald Lavine, D.C.

Dr. Lavine has more than thirty years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods. His website,, provides more information about his approach. Please contact him at or at 212-400-9663.
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