What Are Treatments for Spinal Stenosis?

Some of the best ways to treat the complications and pain of spinal stenosis are also the simplest.

In fact, most doctors will suggest you start with exercise and over-the-counter medications before thinking about something more involved such as surgery.

Spinal stenosis is a narrowing of the canal in your spinal column that affects mostly people age 50 and older. Nothing can cure it, but there are many things you can do on your own, under your doctor's guidance, to enjoy an active life.

Exercise and Physical Therapy

They can go a long way toward easing your symptoms and can also help with:

  • Flexibility
  • Balance
  • Endurance

One study found that a formal physical therapy program was just as good as surgery to improve everyday function. In that study, people did bends, pelvic tilts, standing squats, and other exercises.

Exercise, along with good eating habits, can help you slim down if you’re overweight. This will ease the strain on your spine. Even if you do decide to have surgery, exercising afterward can boost your recovery.

There's no one right way to exercise with this condition -- and some people actually feel better by cutting back if they are overdoing it. So ask your doctor or a physical therapist for ideas.

She will be able to tell you if it's a good idea to add aerobic exercises such as bicycling or swimming. If it is OK, make sure you start slowly.

Sometimes, you can wear corsets or braces around your stomach to make it easier to exercise. If you wear them too much, though, they can backfire and cause your muscles to actually get weaker. This is another thing to ask your doctor about.

Medications

Spinal stenosis is commonly treated with medication, both over-the-counter and prescription.

Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain and inflammation. Examples of over-the-counter NSAIDs are:

Medications that help relieve pain but don't affect inflammation are called analgesics. Acetaminophen (Tylenol) is a common analgesic used for spinal stenosis.

If none of these help, your doctor may prescribe something stronger such as an opiate.

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Side Effects

All medications, even over-the-counter medicines, can have side effects. Too many NSAIDs can cause ulcers and other stomach problems and, especially among older people, may increase the chance of heart attacks and strokes. They might also interact with other medicines.

Always check with your doctor before taking any medications, even those that don't need a prescription.

Injections

Certain injections have the same effect as many medications. Doctors use 2 basic types for spinal stenosis:

Corticosteroids: These can be injected straight into the area around the spinal cord. This is called an epidural injection. Like NSAIDs, steroids work on inflammation and pain. An anesthesiologist or other specialist administers the injection.

Nerve blocks: These are anesthetics injected near the damaged nerves.

Everybody responds differently to these injections. You may get relief for a long time, for a short period, or not at all.

Alternative Treatments

The 2 most common alternative therapies are acupuncture and chiropractic treatment.

Acupuncture: This is a traditional Chinese practice in which someone inserts tiny, flexible needles into you or puts pressure on specific parts of your body to ease pain.

Chiropractic care: Chiropractors try to adjust your spine to reduce pain and improve movement. Some also use traction, which involves pulling bones further apart to make more room for the nerves. Although there isn't a lot of scientific evidence for this, some people say that traction helps them.

You may also benefit from yoga, tai chi (an ancient Chinese exercise routine), or massage.

Surgery

If these treatments don't work, your doctor may suggest surgery, especially if:

  • You're in a lot of pain
  • You have trouble walking
  • You can't control your bladder

In fact, your doctor may recommend surgery first if you have severe symptoms. Like other treatments, surgery is not a cure, but it can help with pain and function.

Your doctor may talk to you about these types:

  • Laminectomy. This is the most common one. A doctor takes out the bone, spurs, and ligaments that are putting pressure on the nerves.
  • Spinal fusion. Doctors sometimes do this along with a laminectomy. It involves joining vertebrae together to reduce movement within the spine.
  • Foraminotomy. A doctor expands the portion of the vertebrae where the nerve roots branch out to the rest of the body.

Recovery can be a few days or up to 3 months. Surgery helps many people but there are also risks, such as blood clots.

WebMD Medical Reference Reviewed by Tyler Wheeler, MD on October 17, 2018

Sources

SOURCES:

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Questions and Answers about Spinal Stenosis."

American College of Rheumatology: "Spinal Stenosis."

Annals of Internal Medicine: “Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis: A Randomized Trial.”

Uptodate.com: "Lumbar spinal stenosis: Treatment and prognosis," "Nonselective NSAIDs: Adverse cardiovascular effects."

Cochrane: "Can exercise give better results after spinal surgery for spinal stenosis?"

Arthritis Foundation: "Spinal Stenosis."

American Academy of Orthopaedic Surgeons: "Lumbar Spinal Stenosis."

Radiological Society of North America: "Epidural Injections."

Cochrane: "Traction for low-back pain."

Cleveland Clinic: "Spinal Stenosis."

Mayo Clinic, “Stress Management -- Tai chi: A gentle way to fight stress.”

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