What is a common clinical presentation for lumbar spinal stenosis?

• A. Severe pain when lying down
• B. Pain alleviated by walking
• C. Symptoms that worsen with sitting
• D. Symptoms that improve with forward bending

Answer: (D)

The common clinical presentation for lumbar spinal stenosis often includes symptoms that improve with forward bending. This is due to the mechanics of the spine and the effect of spinal extension versus flexion. When a person bends forward, it can increase the space in the spinal canal, thereby alleviating pressure on the neural structures, such as the spinal cord and nerves that may be compromised due to stenosis. Patients often report relief from symptoms such as leg pain and numbness during activities that involve bending forward, such as leaning on a shopping cart while walking.

Other positions, such as standing or walking upright, may exacerbate symptoms due to the increased narrowing of the spinal canal in extension, while prolonged sitting can also increase discomfort as it may maintain the spine in a flexed position for too long, causing increased pressure on the affected areas. Thus, patients typically find that forward bending aids in reducing their symptoms, making this option the most representative of the hallmark signs of lumbar spinal stenosis.