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Nonsurgical Treatments
In the absence of severe or progressive nerve involvement, a
doctor may prescribe one or more of the following conservative treatments:
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Nonsteroidal anti-inflammatory drugs, such as aspirin or ibuprofen
(Motrin, Nuprin, Advil), to reduce inflammation
and relieve pain.
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Analgesics, such as acetaminophen (Tylenol), to relieve
pain.
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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.
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Anesthetic injections, known as nerve blocks, near the
affected nerve to temporarily relieve pain.
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Restricted activity (varies depending on extent of nerve
involvement).
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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.
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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
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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.
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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.
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