Certified Neuroscience Registered Nurse (CNRN) Practice Exam

How is back and leg pain associated with lumbar spinal stenosis typically affected by walking uphill?

1. It worsens significantly

2. It remains unchanged

3. It improves somewhat

4. It is relieved only with rest

The correct answer is: It improves somewhat

Walking uphill typically results in improvement of back and leg pain associated with lumbar spinal stenosis. This condition involves the narrowing of the spinal canal, which can lead to increased pressure on the spinal cord and nerves. Patients often experience pain, cramping, or weakness in the legs, particularly during activities such as walking or standing for prolonged periods, a phenomenon commonly referred to as neurogenic claudication. When walking uphill, the posture of the body changes slightly, promoting lumbar flexion. This position can relieve pressure on the nerve roots in the lower back, allowing for improved blood flow and a decrease in pain symptoms. Many patients report finding relief when they lean forward or adopt a flexed position, which is why uphill walking may feel more manageable compared to walking on flat surfaces or downhill. It's important to understand that walking on level ground or downhill often aggravates the pain, as these positions may exacerbate the constriction around the nerves. Hence, the option indicating that pain improves somewhat with uphill walking accurately reflects the experience of many individuals with this condition.