Last reviewed: February 2018
Last updated: January  2017



History and exam

Key diagnostic factors

  • presence of risk factors
  • onset and duration of symptoms
  • back pain
  • activity-related back pain
  • leg pain when walking
  • stooped posture when walking
  • leg numbness or paraesthesiae
  • absence of examination findings

Other diagnostic factors

  • pain radiating down the leg
  • bladder or bowel dysfunction
  • muscle weakness or wasting

Risk factors

  • age >40 years
  • manual labour
  • previous back surgery
  • FHx back pain
  • smoking
  • previous injury
  • achondroplasia
  • acromegaly

Diagnostic investigations

Investigations to consider

  • CT myelography
  • CT spine
  • EMG walking test
Full details

Treatment algorithm


Authors VIEW ALL

Assistant Professor of Orthopaedic Surgery

Dartmouth-Hitchcock Medical Center




AMP is an author of a reference cited in this monograph.

Dr Adam M. Pearson would like to gratefully acknowledge Dr William A. Abdu, Dr John K. Houten, and Dr Mark Chwajol, previous contributors to this monograph. WAA is an author of a reference cited in this monograph. JKH and MC declare that they have no competing interests.

Peer reviewers VIEW ALL

Associate Professor

Department of Neurosurgery

Stanford University




JR declares that he has no competing interests.

Use of this content is subject to our disclaimer