Spinal Stenosis: Treatments

How is spinal stenosis treated?

The preferred treatment for cases of persistent back pain from spinal stenosis is a combination of physical therapy, prescribed exercise, and medications for chronic pain. In some cases, you may benefit from steroid injections for temporary pain relief. Only if you have persistent pain, or if your pain does not respond to these efforts, will your physician consider surgery to relieve the pressure on the affected nerves or on your spinal cord.

Nonsteroidal anti-inflammatory analgesics for chronic pain in spinal stenosis

The most common treatment for chronic pain in spinal stenosis is nonsteroidal anti-inflammatory drugs (NSAIDs). These include:

• Celecoxib (Celebrex)
• Diclofenac (Voltaren)
• Ibuprofen (Advil, Motrin)
• Indomethacin (Indocin, Indocin SR)
• Naproxen (Aleve, Naprosyn)
• Oxaprozin (Daypro)

Anticonvulsants to control pain in spinal stenosis

Two anticonvulsant agents in particular have been found to help with pain control in spinal stenosis by decreasing abnormal electrical activity. These include:

• Carbamazepine (Carbatrol, Equetro, Tegretol)
• Phenytoin (Dilantin, Phenytek, Di-Phen)

Tricyclic antidepressants for chronic pain in spinal stenosis

A tricyclic antidepressant can be helpful in pain management for spinal stenosis, in particular amitriptyline (Elavil, Endep, Vanatrip).

Steroid injections

In some cases, you may benefit from steroid injections for temporary pain relief. These include:

• Cortisone (Celestone, Kenalog)
• Methylprednisolone acetate (Depo-Medrol, Medrol)

Surgical Treatments

In some cases you may need surgery to relieve spinal stenosis, particularly if a disc fragment is lodged in your spinal canal and is pressing on a nerve, which can cause significant loss of function.

What you can do to improve your spinal stenosis

In addition to using medications to reduce chronic back pain, you can also maximize your mobility and minimize stiffness by:

• Attending physical therapy as prescribed by your medical practitioner
• Consulting a chiropractor for pain relief from lumbar stenosis (warn your practitioner if you have osteoporosis or herniated disc)
• Exercising and remaining physically active
• Practicing exercises and lifestyle changes as directed by your medical practitioner or physical therapist

Complementary treatments

Some complementary treatments may help some people to better deal with spinal stenosis and its treatments. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for full medical care.

Complementary treatments may include:

• Acupuncture
• Massage therapy
• Yoga

What are the potential complications of spinal stenosis?

Complications of untreated or poorly controlled spinal stenosis can be serious. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of spinal stenosis include:

• Injury to the legs or feet due to loss of sensation
• Permanent loss of sensation
• Permanent nerve damage or disability
• Permanent or chronic pain
• Worsening of infections due to loss of sensation

References:

Lumbar spinal stenosis. AAOS: American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00329. Accessed May 15, 2011.

Spinal stenosis. PubMed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001477/. Accessed May 15, 2011.