Lumbar Spinal Stenosis - Treatment Overview
If you are experiencing a flare-up of severe low
back pain that is not relieved by other forms of treatment and you are unable
to engage in daily activities, your doctor may prescribe
hydrocodone or other
opioid medicines. But these
medicines do not work well for symptoms that occur in the legs. Also, the side
effects of opioids-such as mental confusion, drowsiness, and constipation-can
be more of a problem than the pain of lumbar spinal stenosis.
you have tried nonsurgical treatment for a period of time as determined by your
doctor but your symptoms have not improved, you may want to
consider surgery. Imaging tests (such as
MRI) will be done to find out the amount and location
of spinal canal narrowing. You and your doctor will want to
discuss the severity of symptoms, along with imaging test results, before
making a decision about surgery.
Back surgery (decompressive laminectomy with or without
spinal fusion) may be considered when you:
- Have severe symptoms of pain, numbness, or
weakness in the legs that restrict normal daily activities and have a negative
impact on your quality of life.
- Are in otherwise good health and do
not have other medical conditions that might make it harder for you to have and
recover from surgery.
The goal of surgery for spinal stenosis is to relieve
pain, numbness, or weakness in the legs-not to relieve back pain. People who
have surgery solely for back pain are less satisfied with outcomes than are
those who have surgery for nerve root symptoms and pain in both the back and
legs. Back pain associated with spinal stenosis is often not relieved by
surgery. Also, numbness, weakness, and pain may return after
Spinal stenosis: Should I have surgery?
What To Think About
Epidural steroid injections
(ESIs) are usually only used to treat symptoms of lumbar spinal stenosis that
occur in the legs. This treatment does not always work. And when it does work, it may only relieve symptoms for a short time. Experts are not sure about the long-term effects. Talk to your doctor about the
risks related to the number of injections he or she expects you will
Surgery is usually not recommended for an older adult who
is able to manage symptoms with nonsurgical treatment and is able to do normal
daily activities. Surgery may be considered if the severity of symptoms and the
decrease in quality of life outweigh the risks of the procedure. Surgery may
not be an option for some older adults whose other serious health problems
increase the risks from surgery.