What is the clinical presentation of spinal stenosis?

The clinical presentation of spinal stenosis is characterized primarily by lower back pain that is often exacerbated by walking and prolonged standing. This condition typically involves narrowing of the spinal canal, which can compress the spinal cord and nerves. As a person moves or stands for extended periods, the resulting pressure on the neural structures can lead to symptoms like pain, numbness, or weakness.

Patients with spinal stenosis often describe their pain as an aching or cramping sensation in the lower back that may radiate into the buttocks, legs, or feet. This discomfort commonly improves when they sit down or lean forward, allowing the spinal canal to open up slightly. This symptom pattern is particularly characteristic and helps differentiate spinal stenosis from other potential conditions.

The other symptoms presented in the options do not align with the typical clinical features of spinal stenosis. Neuropathic pain in the hands suggests a different underlying pathology, potentially involving cervical radiculopathy or peripheral neuropathy. Weight loss and fever are more indicative of an inflammatory or infectious process. Sudden onset of leg weakness could indicate an acute neurological event, such as a herniated disk or spinal cord injury, rather than the gradual progression commonly seen with spinal stenosis.