Groin Pain (non-traumatic)

Lumbar Spinal Stenosis

Hip and groin pain secondary to lumbar stenosis can manifest as low back pain that radiates to the lower extremities.  However, presence of several risk factors and red flags should alert the therapist to refer the patient to a physician.

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Physical Findings & Clinical Presentation

  • Symptoms caused by direct mechanical compression or indirect vascular compression of the nerve roots or the cauda equina.
  • Neurogenic claudication: leg, buttock, or back pain precipitated by walking and relieved by sitting
  • Pain may radiate down to ankles and is associated with numbness, tingling, and weakness.
  • Taking a flexed posture reduces symptoms because it increases the available space in the lumbar spinal canal.
  • Decreased lumbar extension.
  • Normal peripheral pulses.
  • Positive Romberg’s sign (decreased proprioception).
  • Wide-based gait.
  • Reduced knee and ankle reflex.
  • Urine incontinence.

Special Tests

    • Phalen’s Test for Lumbar Stenosis
    • Bicycle van Gelderen's Test (Goodman and Snyder 2007)
    • Repeated Movement Testing
    • Imaging