Back Pain Health Center

Lumbar spinal stenosis is narrowing of the spinal canal that usually starts gradually and develops over a long period of time. As the spinal canal narrows, it can squeeze (compress) and irritate the nerve roots that branch out from the spinal cord , or it can squeeze and irritate the spinal cord itself. The goals of treatment for spinal stenosis are to relieve pain, numbness, and weakness in the legs, to make it easier for you to move around (improve function), and to improve your quality of life. Treatment includes pain-relieving medicine, exercises, and other nonsurgical measures, and in some cases, surgical treatment.

Initial treatment

Unless your lumbar spinal stenosis is severe, initial treatment usually is aimed at relieving your symptoms without surgery. Most cases do not require surgery. Nonsurgical treatment often works to allow most normal activity and relieve mild to moderate symptoms of pain, numbness, and weakness in the legs.

Nonsurgical treatment includes:

• Education about the course of your condition and how to relieve symptoms.
• Medicines to relieve pain and inflammation, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).
• Exercise, to maintain or achieve overall good health. Aerobic exercise-especially riding a stationary bicycle (which allows you to lean forward)-can relieve symptoms.
• Weight loss, to relieve symptoms and slow progression of the stenosis.
• Physical therapy, to provide education, instruction, and support for your self-care. Physical therapy helps you learn stretching and strength exercises that may lead to a decrease in pain and other symptoms.

If you have symptoms of cervical spinal stenosis, testing and treatment may be done earlier than in treatment for lumbar spinal stenosis.

Ongoing treatment

Lumbar spinal stenosis often requires nonsurgical treatment on an ongoing basis. Treatment may include:

• Medicines to relieve pain and inflammation, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).
• Exercise, which is important for overall good health. Aerobic exercise-especially riding a stationary bicycle (which allows you to lean forward)-can relieve symptoms.
• Staying at a healthy body weight, which may relieve symptoms and slow the progression of the stenosis.
• Physical therapy, to provide education, instruction, and support for your self-care. Physical therapy helps you learn stretching and strengthening exercises that may lead to a decrease in pain and other symptoms.

If medicines, exercise, and physical therapy do not relieve your symptoms, your doctor may recommend an epidural steroid injection (ESI). This injection includes a combination of a corticosteroid and a local anesthetic pain relief medicine. These injections are used for pain that occurs mostly in the legs.

Treatment if the condition gets worse

The course of lumbar spinal stenosis varies. Symptoms may be severe at times and less severe at other times. If you feel numbness, weakness, or have trouble standing or walking, it may mean that your condition is getting worse. Problems with bladder and bowel control also may mean your spinal stenosis is getting worse.