Neurogenic Claudication: Causes, Symptoms, Treatment and Cost

Neurogenic claudication is a condition that occurs when the nerves in the lower spine become compressed, causing pain and weakness in the legs.

• Mechanical Neurogenic Claudication :Mechanical neurogenic claudication is caused by mechanical compression on the nerves in the spine due to narrowing of the spinal canal. Examples include lumbar spinal stenosis, herniated disks, and degenerative disk disease.
• Vascular Neurogenic Claudication: Vascular neurogenic claudication occurs when there is insufficient blood flow to parts of the leg due to peripheral artery disease (PAD).

Common causes of spinal stenosis include aging, physical trauma, such as a car accident or fall; herniated discs; spinal tumors; and arthritis. Other factors that may increase your risk for neurogenic claudication include being overweight and having an occupation that requires a lot of bending or stooping.

Common symptoms include: cramping in the legs and buttocks; heaviness in the legs; loss of balance when standing or walking; difficulty walking long distances; foot drop; and urinary urgency or incontinence.

Other symptoms may include tingling sensations, burning sensations, decreased sensation to touch, and difficulty rising from a seated position.

• Exercise regularly to maintain good physical health and improve circulation.
• Avoid activities that put pressure on the spine, such as heavy lifting.
• In order to ease the strain on your spine and nerves, keep your weight within a healthy range.
• If you need to stand or sit for lengthy periods of time, be sure to wear shoes with good arch support and keep a good posture.
• Practice good body mechanics when performing activities to reduce stress on the spine and nerves.
• Participate in regular physical therapy prescribed by a doctor for specific exercises to help maintain strength, flexibility, and range of motion in the spine and legs muscles to reduce symptoms of neurogenic claudication

• Physical examination: A physical examination is done to assess the patient's symptoms, such as leg pain, weakness, and cramping, and to look for any physical signs of spinal cord or nerve root compression.
• Imaging tests: Imaging tests such as MRI or CT scans are done to assess the spinal cord and nerve roots for any signs of compression or damage. Any structural abnormalities that might be triggering the neurogenic claudication symptoms can be found with the use of these medical technologies.
• Nerve conduction study: This test measures the electrical activity of the nerves to evaluate nerve function and detect any abnormalities that may be contributing to the patient's symptoms.
• Electromyogram (EMG): An electromyogram test measures the electrical activity of the muscles to evaluate muscle strength and detect any abnormalities that may be contributing to the patient's symptoms.

• Reduced mobility, leading to increased risk of falls and fractures.
• Tingling/numbness in the legs or feet due to nerve compression.
• Muscle weakness or spasms due to impaired nerve function.
• Increased risk of skin breakdown due to decreased sensation.
• Pain that worsens while standing or moving around for lengthy periods of time.
• Urinary retention caused by bladder muscle weakness.

• Ashwagandha: It is considered that ashwagandha helps increase circulation and lower inflammation, both of which can help decrease the pain associated with neurogenic claudication.
• Triphala: Triphala is a blend of three herbs—amalaki, bibhitaki, and haritaki—that has been used for centuries in Ayurveda to improve overall health and well-being. It is believed to be particularly beneficial for improving circulation and reducing inflammation, which can help alleviate the symptoms of neurogenic claudication.
• Bala: Bala is an herbal remedy commonly used in Ayurveda for treating a variety of conditions, including neurogenic claudication. It is believed to boost circulation as well as decrease inflammation, both of which may help alleviate the pain that is linked with this disorder.
• Guggul: Guggul is a kind of herb that is often used in the Ayurvedic system of medicine to treat a wide range of conditions, one of which is neurogenic claudication. It enhances circulation and reduces inflammation.
• Shilajit: Shilajit is an herbal remedy commonly used in Ayurveda for treating a variety of conditions, including neurogenic claudication. It is believed to strengthen blood vessels and reduce inflammation, which can help alleviate the symptoms of this condition

• A proper diet with fruits, vegetables, whole grains, lean meats, and healthy fats may help regulate neurogenic claudication.
• Foods high in fiber and low in saturated fat can help reduce inflammation in the body and improve blood flow to the legs.
• Omega-3 fatty acids present in fatty fish such as salmon, sardines, and mackerel may help lessen inflammation and promote neurological function.
• Avoid processed foods high in sodium as they can increase fluid retention and worsen symptoms of neurogenic claudication.
• Include magnesium-rich foods such as almonds, bananas and spinach to help relax muscles and reduce leg cramps associated with neurogenic claudication.

• Foods high in saturated fat: These can lead to increased cholesterol levels, which can cause blockages in the arteries and interfere with blood flow to the legs.
• Processed foods and refined sugar: These can cause inflammation, which may worsen symptoms of neurogenic claudication.
• High sodium foods: Salt intake should be limited as it can increase fluid retention and worsen symptoms of neurogenic claudication.
• Caffeine and alcohol: These drugs may raise blood pressure and heart rate, causing neurogenic claudication symptoms to aggravate.
• Fried foods: These are high in saturated fats and may worsen symptoms of neurogenic claudication by causing inflammation or narrowing of the arteries.

• Laminectomy: A section of the lamina (the back part of the vertebral bone) is removed to make place for the spinal cord and nerve roots.
• Discectomy: Removal of a portion of a herniated or bulging disc that is compressing the spinal cord or nerves.
• Foraminotomy: To ease nerve compression, the foramen (the hole in the spine where the nerve roots leave) is enlarged.
• Spinal fusion: Joining two or more vertebral bones together to stabilize the spine and prevent further nerve compression.
• Scoliosis correction: Correction of any abnormal curvature of the spine that may be compressing the nerves.
• Artificial disc replacement: Replacement of a damaged or worn-out disc with an artificial one to relieve nerve compression
• Spinal cord stimulation: The implantation of a device that transmits electrical impulses to the spinal cord to alleviate pain and enhance function.

The best doctor to consult for this condition would be an orthopedic surgeon or a neurologist.

• Pain relievers: Nonsteroidal anti-inflammatory medicines (NSAIDs), like ibuprofen or naproxen, may help ease the pain and inflammation caused by Neurogenic Claudication.
• Muscle relaxants: These medications can help reduce muscle spasms associated with Neurogenic Claudication. Examples include cyclobenzaprine, tizanidine, and dantrolene sodium.
• Blood pressure medications: Beta-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors can be used to reduce the effects of hypertension in people with Neurogenic Claudication caused by vascular disease.
• Vasodilators: These medications can widen blood vessels to improve blood flow in patients with neurological issues causing Neurogenic Claudication symptoms. Examples include nifedipine and nicardipine hydrochloride.
• Antidepressants: Tricyclic antidepressants like amitriptyline have been shown to be effective for reducing pain associated with Neurogenic Claudication in some patients due to their ability to block pain signals from being sent from the peripheral nerves to the brain.

Recovery period may often vary from a few weeks to many months when the root cause is managed.

In some cases, the results of treatment for neurogenic claudication can be permanent.

For example, surgical intervention may result in a lasting improvement in symptoms and reduced risk of recurrence. .

• Rest: Adequate rest is important to allow the body to heal and reduce swelling or inflammation in the area operated on.
• Physical therapy: Physical therapy can help with stretching exercises, strengthening exercises, and range of motion exercises that help improve flexibility in affected muscles and joints. It can also help you learn how to properly use your body when performing activities without making your condition worse.
• Pain relief medications: To minimize pain and inflammation in affected regions, nonsteroidal anti-inflammatory medications (NSAIDs) may be recommended. Some doctors may also prescribe muscle relaxants or narcotics if necessary to control pain symptoms.
• Supportive devices: Braces or orthopedic supports such as a lumbar support belt are often recommended after surgery to provide extra support while walking or performing other activities that might aggravate symptoms of neurogenic claudication.
• Follow-up visits: Follow up visits with your doctor are important so they can monitor your progress and make any necessary changes to your post-operative care plan if needed.

Generally, treatment for Neurogenic Claudication can range from Rs. 10,000 to Rs. 1 lakh or even more depending on the diagnosis and treatment.

The price may also vary depending on whether you choose medication or surgery to address the illness.

The following are examples of typical negative reactions to treatments:

• Medications: It is possible for some medicines, like nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants, to cause side effects such as tiredness, dizziness, and stomach problems.
• Surgery: Risks associated with surgery include infection, bleeding, nerve damage, and failure of the procedure which may require additional surgery. Additionally, pain and weakness may persist or worsen after surgery.

If you are suffering from any complications relating to Neurogenic Claudication then you should consult a doctor nearby as they can cause complications like 'worsening of symptoms, development of chronic pain, and potential progression to spinal cord compression or nerve damage' in which treatment courses can range from a few months to years depending on the severity of the situation.