Story by: Norton Healthcare on November 25, 2022
Weakness in your legs when walking can have several causes. If you are having symptoms of a stroke, contact 911 immediately.
Other conditions may not be an emergency, but warrant evaluation by a health care professional. Often, the cause of weakness or pain in the legs when walking is a narrowing of the space around nerves that carry signals to the lower part of the body. When symptoms affect your legs, the condition is typically lumbar spinal stenosis.
The spinal cord is a bundle of nerves that runs from the brain down your back, with nerves branching outward to nearby parts of the body. Bone — vertebrae — and other tissue surround and protect the spinal cord and other nerves. With aging, bone spurs can develop that narrow the space for the nerves, putting pressure on them. The result can be weakness and often numbness, along with leg and back pain when walking, climbing stairs or other activities that involve moving while upright.
“Spinal stenosis typically develops later in life, but some patients can be born with congenital spinal stenosis that can produce symptoms at a younger age,” said Kirk Owens, M.D., orthopedic spine surgeon with Norton Leatherman Spine.
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Spinal stenosis most often develops in the lower back. When it happens in the neck, symptoms can include neck pain, numbness or tingling that radiates down the arms into the hands, and weakness in the arms, hands or fingers.
For many, the weakness in the legs starts when walking or when they first stand up. Pain may start in the buttocks and radiate down to the feet. This should be distinguished from pain that starts in the feet and then radiates up the legs, which can be caused by inadequate blood flow to the feet.
“A classic sign of lumbar spinal stenosis is pain and weakness in the legs when walking,” Dr. Owens said. “Often, symptoms improve when the patient stops walking, leans forward while standing or walking, or sits down. These positional changes help to relieve pressure on the nerves.”
Weakness in the legs while walking helps differentiate spinal stenosis from a herniated disc, which is more likely to result in sciatica pain shooting down one leg or another whether moving around or not.
Physical therapy to strengthen the back muscles and improve posture is the first line of treatment along with anti-inflammatory medication, according to Dr. Owens. In severe cases, your medical provider may recommend surgery. The procedure — lumbar laminectomy — removes parts of the bone tissue impinging on the nerves and has a high success rate.
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