Next to general questions, ask about:
- Age: LSS affects mainly older individuals, typically between 50 and 60, although the congenital type may occur earlier (Bierma-Zeinstra et al. 2006)
- Previous LB problems: LSS affects individuals with a prolonged history of low back pain (Delitto et al. 1998, NASS 2011)
- Pain pattern: In the lower extremity, severe pain may occur (Bayley et al. 1995, Cole et al. 2009) as well as radiating pain (Casey et al. 2007, Cole et al. 2009). Leg pain may be unilateral or bilateral, with typically a more recent onset than the low back pain (Delitto et al. 1998).
- Activities influencing the pain: There is absence or improvement of pain in sitting (Bayley et al. 1995; Delitto et al. 1997; Casey et al. 2007, NASS 2011) and forward bending, whereas standing increases symptom severity (NASS 2011).
- Walking: Limited walking tolerance is often the reason for seeking medical attention (Delitto et al. 1998). Many LSS patients reported that their back pain intensified with prolonged walking (Iversen et Katz 2001, NASS 2011). Patients often describe walking uphill easier than walking on a flat surface (Jackson et Simpsons 2006).
- Biking: Patients can often cycle even if they cannot walk (Jackson et Simpsons 2006). Reason for this might be neurogenic claudication (Delitto et al. 1998; Jackson et Simpsons 2006).
The overall quality of available research is poor (Bierma-Zeinstra et al. 2006). The best available evidence concludes that older age and gluteal/lower extremity symptoms worsening by walking/standing improving with sitting/bending forward are low evidence findings. All other findings are of insufficient evidence (NASS 2011).
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Lumbar Spine Assessment 