Typically, these patients complain of finger numbness, clumsiness, and difficulty walking due to spasticity and loss of position sense. In more severe cases, the patients can have bowel and bladder control dysfunction. Upon examination, these patients have long-tract signs such as hyperreflexia and clonus. When patients bend forward, the pain reduces. Patients often suffer for years because they mistakenly accept their symptoms as an inevitable part of aging.
Early treatment is important for a better outcome.
When a patient presents with signs and symptoms of myelopathy or cauda equina syndrome, urgent surgical decompression of the spinal cord or nerve roots is indicated. Significant muscle weakness due to nerve root impingement is also a strong indication for surgical intervention. If the patient already has developed muscle atrophy, a full regain of muscle strength would not be expected even after surgical decompression. Radicular pain is the commonest symptom of spinal stenosis, and thus the most common indication for surgery. Pain is a totally subjective complaint, and there is no reliable objective means to measure pain severity.