National Board of Chiropractic Examiners (NBCE) Practice Test

A 60-year-old patient with lower lumbar central spinal canal stenosis is most likely to demonstrate ________________.

1. Increased pain when standing

2. Relief of pain when flexing forward

3. Intense pain with extension

4. Unilateral leg weakness

The correct answer is: Relief of pain when flexing forward

A patient with lower lumbar central spinal canal stenosis typically experiences symptoms due to the narrowing of the spinal canal, which can lead to compression of nerve roots and the spinal cord. In this case, the correct answer highlights the characteristic relief of pain that often occurs when the patient flexes forward. This relief happens because forward flexion increases the space in the spinal canal, thereby reducing pressure on the nerve structures that may be compressed by the stenosis. Patients often find a comfortable position when they lean forward, which leads to a decrease in symptoms such as pain or discomfort in the lower back and legs. In contrast, standing can exacerbate symptoms due to an upright position that narrows the canal further. Intense pain with extension is also common as extending the spine increases the pressure on the already compromised spinal canal. Unilateral leg weakness may occur with certain presentations of stenosis, but it is less characteristic than the bilateral symptoms experienced with central stenosis.