Which of the following is not a characteristic of spinal stenosis?

In the context of spinal stenosis, the hallmark characteristics include symptom patterns that typically involve pain in the lower back and legs, which are often exacerbated by activities like walking and standing. Of the options provided, the acute onset of bilateral leg pain is not characteristic of spinal stenosis. Instead, symptoms of spinal stenosis usually develop gradually over time rather than appearing suddenly.

The other options accurately reflect typical presentations of spinal stenosis. Thigh pain relieved by sitting is common because flexing at the hips can decrease pressure on the spinal canal. Back pain accompanied by buttocks pain aligns with the radicular or referred pain patterns often seen in this condition. Additionally, symptoms improving with rest is also a characteristic feature, as rest tends to alleviate the pressure and irritation caused by the stenosis. Thus, the correct choice highlights a symptom presentation that is atypical for spinal stenosis.