Can T10 to T11 spinal stenosis cause flank pain and pain on hip flexion?

From the Guidelines

Yes, T10 to T11 spinal stenosis can cause flank pain and pain on hip flexion. Spinal stenosis at the thoracic level (T10-T11) can compress nerve roots that innervate the flank area, leading to radiating pain in the side of the abdomen or back. When you flex your hip, this movement can increase pressure on the already compressed nerves or change the alignment of the spine, exacerbating the pain.

Key Points to Consider

• The T10-T11 nerve roots specifically supply sensation to parts of the flank and can refer pain to the hip area, explaining why these particular symptoms occur with stenosis at this level 1.
• Treatment typically includes pain management with NSAIDs like ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily), physical therapy focusing on core strengthening and proper posture, and possibly epidural steroid injections for more severe cases 1.
• In some instances where conservative treatments fail, surgical decompression may be necessary 1.
• The pain occurs because spinal stenosis narrows the spinal canal or neural foramina, putting pressure on the spinal cord or nerve roots that exit at these levels 1.

Important Considerations for Management

• Clinicians should provide patients with evidence-based information on low back pain with regard to their expected course, advise patients to remain active, and provide information about effective self-care options 1.
• Magnetic resonance imaging (preferred if available) or CT is recommended for evaluating patients with persistent back and leg pain who are potential candidates for invasive interventions—plain radiography cannot visualize discs or accurately evaluate the degree of spinal stenosis 1.

From the Research

Spinal Stenosis and Pain

• T10 to T11 spinal stenosis can cause a range of symptoms, including lower back pain and neurogenic claudication (NC) 2.
• The narrowing of the space within the vertebral canal and or intervertebral foramina can result in the compression of the spinal cord and possibly the roots of the spinal nerves, leading to pain 2.

Flank Pain and Hip Flexion

• While the provided studies primarily focus on lumbar spinal stenosis, it is possible that T10 to T11 spinal stenosis could lead to flank pain and pain on hip flexion due to the compression of nerves that innervate these areas 3.
• However, the studies do not provide direct evidence for this specific condition, and more research would be needed to confirm this association.

Treatment and Management

• Treatment options for spinal stenosis include non-invasive methods such as physical exercises, epidural corticosteroid injection, and oral analgesics, as well as surgical intervention 2, 3.
• Surgical intervention, such as decompressive laminectomy, may be effective in managing pain and improving function in carefully selected patients 3.
• Chiropractic management, including flexion-distraction manipulation, may also be a viable treatment option for some patients with spinal stenosis 4.

Prognosis and Predictors

• The prognosis for persons with spinal stenosis is not well studied, but research suggests that clinically recognized spinal stenosis is fluctuating and largely improving 5.
• Initial disability measures, such as ambulation velocity and Pain Disability Index, may predict future function and pain in persons with spinal stenosis 5.