Presentation, Diagnosis, and Management of Lower Back Pain Associated with Spinal Stenosis: A Narrative Review

23 February 2023 : Review article

Dawid Sobański^12ADEF*, Rafał Staszkiewicz^13ADEF, Magdalena Stachura^24EF, Marcin Gadzieliński^3EF, Beniamin Oskar Grabarek^13AEF

DOI: 10.12659/MSM.939237

Med Sci Monit 2023; 29:e939237

Background Causes of Pain Syndromes of the Lumbar Spine General Characteristics of Degenerative Stenosis of the Lumbar Region of the Spine Pathomechanism of Pain Syndromes of the Spine Clinical Symptoms for Patients with Stenosis of the Lumbar Region of the Spine Differentiation in Degenerative Stenosis of the Lumbar Spine Radiological Diagnosis of Patients with Degenerative Lumbar Stenosis of the Spine Pharmacotherapy, Rehabilitation, and Surgical Treatment of Patients with Degenerative Lumbar Spine Stenosis Rehabilitation Treatment of Patients with Degenerative Lumbar Spine Stenosis Future Directions Conclusions References

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Table 3 Categories of spinal pain according to the structures, which may be the potential source of back pain.

Category	Cause of pain
Skeletal	Occurs as a result of irritation of receptors of perivascular blood vessels of the cancellated bone of intervertebral bodies and arches, as a consequence of mechanical damage, eg, fractures of intervertebral bodies in osteoporosis, osteomalacia, injuries, or cancers
Musculo-articular, fascial, and ligament	As a consequence of chemical or mechanical irritation of nociceptive receptors of such perispinal structures as joint capsules, tendons, aponeuroses, ligaments
Vascular	As a result of mechanical irritation (due to venous stasis and vein distention caused by elevated venous pressure in the area of the abdomen and the chest) of nerve endings located in the walls of the vertebral venous plexuses
Neurological	Meaning secondary pain occurring as a result of the dysfunction of nerves connecting the spinal cord with the peripheral system of receptors of perispinal tissues
Dural	Connected with pressure on the front part of the dura mater

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