FYI

• Stenosis improves with flexion
• Herniation worsens with flexion + is often acute following inciting event

• Pain in the hips/thighs that is exacerbated by walking and improves with leaning forward with normal posterior tibial pulses, most consistent with pseudoclaudication due to spinal stenosis
• Claudication: Patient will have risk factors for peripheral vascular disease (diabetes, HTN, smoking, etc.), reduced lower extremity pulses, reduced lower extremity temperature, pain classically in the calves, reduced hair on legs
• Pseudo-claudication (spinal stenosis): Positional (improves with flexion), classically affects buttocks and thighs, may be associated with back pain

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