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Spinal Stenosis Treatment

Nonsurgical Treatments

In the absence of severe or progressive nerve involvement, a doctor may prescribe one or more of the following conservative treatments:

  • Nonsteroidal anti-inflammatory drugs, such as aspirin or ibuprofen (Motrin, Nuprin, Advil), to reduce inflammation and relieve pain.

  • Analgesics, such as acetaminophen (Tylenol), to relieve pain.

  • Corticosteroid injections into the outermost of the membranes covering the spinal cord and nerve roots to reduce inflammation and treat acute pain that radiates to the hips or down a leg.

  • Anesthetic injections, known as nerve blocks, near the affected nerve to temporarily relieve pain.

  • Restricted activity (varies depending on extent of nerve involvement).

  • Prescribed exercises and/or physical therapy to maintain motion of the spine, strengthen abdominal and back muscles, and build endurance, all of which help stabilize the spine. Some patients may be encouraged to try slowly progressive aerobic activity such as swimming or using exercise bicycles.

  • A lumbar brace or corset to provide some support and help the patient regain mobility. This approach is sometimes used for patients with weak abdominal muscles or older patients with degeneration at several levels of the spine.

 

Surgery

Your doctor will likely suggest nonsurgical treatment first. However, surgery might be considered immediately if a patient has numbness or weakness that interferes with walking, impaired bowel or bladder function, or other neurological involvement.

The purpose of surgery is to relieve pressure on the spinal cord or nerves and restore and maintain alignment and strength of the spine. This can be done by removing, trimming, or adjusting diseased parts that are causing the pressure or loss of alignment. The most common surgery is called decompressive laminectomy: removal of the lamina (roof) of one or more vertebrae to create more space for the nerves. A surgeon may perform a laminectomy with or without fusing vertebrae or removing part of a disk. Various devices may be used to enhance fusion and strengthen unstable segments of the spine following decompression surgery.

The most common complications of surgery for spinal stenosis are a tear in the membrane covering the spinal cord at the site of the operation, infection, or a blood clot that forms in the veins. These conditions can be treated but may prolong recovery. The presence of other diseases and the physical condition of the patient are also significant factors to consider when making decisions about surgery.

Alternative Treatments

  • Chiropractic treatment—This treatment is based on the philosophy that restricted movement in the spine reduces proper function and may cause pain. Chiropractors may manipulate (adjust) the spine in order to restore normal spinal movement. They may also employ traction, a pulling force, to help increase space between the vertebrae and reduce pressure on affected nerves. Some people report that they benefit from chiropractic care. Research thus far has shown that chiropractic treatment is about as effective as conventional, nonoperative treatments for acute back pain.

  • Acupuncture—This treatment involves stimulating certain places on the skin by a variety of techniques, in most cases by manipulating thin, solid, metallic needles that penetrate the skin. Research has shown that low back pain is one area in which acupuncture has benefited some people.

More research is needed before the effectiveness of these or other possible alternative therapies can be definitively stated.

 

Reference:

National Institute of Arthritis and Musculoskeletal and Skin Diseases, USA.