What is the primary symptom of spinal stenosis?

• A. Leg pain that worsens with standing.
• B. Leg numbness that improves with activity.
• C. Leg pain that improves when sitting.
• D. Back pain with no leg symptoms.

Answer: (C)

Spinal stenosis classicly causes neurogenic claudication, where leg pain or cramping is triggered by standing or walking and is relieved by sitting or bending forward. Extending the spine narrows the already tight spinal canal, worsening nerve compression; sitting reduces lordosis and opens the canal, easing symptoms. That relief with sitting is the hallmark, making leg pain that improves when sitting the best description. Other patterns—pain that only appears with standing, numbness that gets better with activity, or back pain without leg symptoms—don’t fit the typical nerve-compression pattern seen in spinal stenosis.