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What the ‘Shopping Cart Sign’ Can Tell You About Your Back Pain

As you get older, you’re more likely to develop back problems. And sometimes, it can be tricky to uncover what’s causing your symptoms. The “shopping cart sign” is a clue that lumbar spinal stenosis might be behind your lower back trouble.

What does a shopping cart have to do with back pain and lumbar spinal stenosis? “One of the interesting things about this particular type of spine problem is that we will often ask people if their pain is relieved by leaning forward,” said Dr. Robert Bina, MD, a neurosurgeon at Banner - University Medical Center Phoenix. People often lean forward when they push a shopping cart. If this action alleviates their pain, it can help point doctors toward an accurate diagnosis.

Lumbar spinal stenosis stems from arthritis in your spine. “Arthritis causes changes in the joints and discs in your lower back that make the spinal canal narrower,” Dr. Bina said. “It’s like build-up in a pipe.” The narrower spinal canal puts pressure on the nerves that lead to your legs and feet and can cause pain, numbness or weakness.

Who is at risk for lumbar spinal stenosis?

Age is a risk factor, so your likelihood of developing lumbar spinal stenosis increases as you get older. You’re also at higher risk if you smoke, are obese, have a family history of back problems, or use your back a lot as part of your job.

What are the symptoms of lumbar spinal stenosis?

Along with pain that improves when you lean forward, symptoms include:

  • Pain that shoots down your leg from the back to the thigh, leg or foot (sciatic-type pain)
  • Back and leg pain that worsens when you move and improves when you rest
  • Numbness or tingling in your leg
  • Weakness in your foot or knee

How can I reduce my lower back pain?

To reduce pain at home, Dr. Bina said you can try:

“Keeping as physically active as you can, losing weight and stopping smoking can really help as well,” Dr. Bina said.

When should I see a doctor?

If the steps you’re taking at home to reduce your pain aren’t working, talk to your primary care provider (PCP). “Pain that doesn’t respond to over-the-counter medications or any of the at-home treatments, or leg or foot weakness of any sort, needs to be evaluated by a PCP,” Dr. Bina said.

Your PCP may order an x-ray, CT scan, or MRI of your lower back to help make a diagnosis. They may also refer you to a pain management doctor, neurosurgeon or orthopedic spine surgeon.

“A pain management doctor has a variety of treatments that can be effective, like nerve blocks, steroid injections and other treatments,” Dr. Bina said. “The benefit of these treatments is that they aren’t surgical and can often help reduce pain and confirm a diagnosis.”

A surgeon can explain the pros and cons of a procedure called a laminectomy that can help take the pressure off the nerves in your spine. Rarely, a surgeon will recommend fusion surgery.

The bottom line

As you get older, you might develop lower back pain that stems from lumbar spinal stenosis. At-home treatments can often help to control the pain. If they don’t work, talk to your primary care provider about injections and other treatment options. If you need to connect with a doctor to diagnose your back pain, Banner Health can help.

These articles can help you learn more about back problems:

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