What is the impact of extension on stenosis-related pain?

Extension typically increases stenosis-related pain due to the mechanics of spinal alignment and the anatomy of the lumbar region. When the spine extends, there is increased pressure on the intervertebral foramen and potentially on the spinal cord itself, which can exacerbate symptoms in individuals with spinal stenosis. This is especially relevant in cases where the spinal canal is already narrowed, as extension may further compress the nerve roots or the accompanying structures.

Patients with lumbar spinal stenosis often find relief in a flexed position, as this can open up the space in the foramina, thereby reducing pressure on the nerves. Thus, the mechanical effects on the structures around the spine during extension contribute to an increase in discomfort and pain for individuals with existing stenosis.