Last reviewed: 15 Sep 2021
Last updated: 05 Oct 2018

Summary

Definition

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
  • family history of back pain
  • smoking
  • previous injury
  • achondroplasia
  • acromegaly

Diagnostic investigations

Treatment algorithm

Contributors

Authors

Adam M. Pearson, MD, MS

Assistant Professor of Orthopaedic Surgery

Dartmouth-Hitchcock Medical Center

Lebanon

NH

Disclosures

AMP is an author of a number of references cited in this topic.

Acknowledgements

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 topic. WAA is an author of a reference cited in this topic. JKH and MC declare that they have no competing interests.

Peer reviewers

John Ratliff, MD, FAANS, FACS

Associate Professor

Department of Neurosurgery

Stanford University

Stanford

CA

Disclosures

JR declares that he has no competing interests.

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