Comprehensive Osteopathic Medical Licensing Examination (COMLEX USA) Practice

How does the pain associated with spinal stenosis typically present?

1. Localized and sharp

2. Radiates to buttocks, thighs, legs

3. Worse with rest

4. Acute and severe

The correct answer is: Radiates to buttocks, thighs, legs

The presentation of pain associated with spinal stenosis is characterized by radicular symptoms that commonly radiate to the buttocks, thighs, and legs. This occurs due to the narrowing of the spinal canal or foramen, which can compress spinal nerves as they exit the vertebrae. Patients often describe this pain as a cramping or aching sensation that can occur during activities like walking or standing, but typically improves with rest or when sitting down. The neurologic symptoms might also include weakness or numbness in the affected areas, aligning with the radiating nature of the pain. Other presentations, such as localized and sharp pain, may not accurately capture the characteristic pattern of discomfort associated with spinal stenosis. Similarly, while patients may experience worsening of symptoms with activity, the pain in spinal stenosis is usually alleviated by rest, making this distinction significant. Acute and severe pain is more characteristic of conditions such as herniated discs or fractures, rather than the more chronic nature of spinal stenosis pain. This context highlights the importance of understanding the typical radiating symptom pattern when assessing patients for spinal stenosis.