A 70-year-old male presents with leg pain that worsens with back extension. What is the likely diagnosis?

The symptoms presented by the 70-year-old male suggest lumbar spinal stenosis is the likely diagnosis. This condition typically manifests as leg pain or discomfort that is exacerbated by activities that involve back extension, such as walking uphill or standing for prolonged periods. The reason for this is that in lumbar spinal stenosis, the narrowing of the spinal canal can cause compression of the spinal nerves, leading to pain, numbness, or weakness, particularly when the spine is in an extended position.

In this case, the variation in pain associated with back extension aligns perfectly with the typical presentation of lumbar spinal stenosis, as patients often find that bending forward or sitting relieves their discomfort. This characteristic feature, known as "neurogenic claudication," differentiates it from other conditions.

Other options may present leg pain but do not typically worsen specifically with back extension. For instance, while a herniated disc can cause similar symptoms, it often leads to increased pain with certain movements related to disc pathology rather than back extension specifically. Osteoarthritis may contribute to back pain but does not usually have the specific extension-related symptom pattern seen in stenosis. Peripheral artery disease primarily presents with claudication related to ischemia rather than positional changes of the spine. Hence,