Treatment. Spinal Stenosis

Spinal Stenosis Treatment Options

These diagnostic studies are usually performed if symptoms do not subside after a period of 3 to 6 months of therapy, such as rest, anti-inflammatory medications, and physical therapy. Neuronal studies include the following:

• Needle electromyography – Can help to diagnose lumbosacral radiculopathy with axonal loss
• Nerve conduction studies – Can help to differentiate lumbar spinal stenosis (LSS) from other confounding neuropathic conditions (e.g., lumbosacral plexopathy, generalized peripheral neuropathy, tarsal tunnel syndrome, other mononeuropathies)
• Somatosensory evoked potentials are useful in diagnosing central nervous system (CNS) pathology and are also used intraoperatively during decompressive surgery to assist the physician in dynamically identifying any iatrogenic changes to the sensory pathways.

The spinal stenosis treatment options vary, depending on how severe the signs and symptoms are and where the condition has occurred in your spine.

Spinal stenosis medications

Several different spinal stenosis treatment options may be recommended by your physician, including medications. The goal of medications for spinal stenosis is to relieve the pain caused by the condition.

• Non-steroidal anti-inflammatory drugs: These are also known as NSAIDs. They help ease the pain of spinal stenosis by reducing inflammation and decreasing the body’s response to pain. Examples are naproxen and ibuprofen. Some NSAIDs can be purchased over-the-counter. Other NSAIDs such as COX-2 inhibitors require a physician’s prescription.
• Muscle Relaxants: Muscle relaxants are effective in treating spinal stenosis pain because they reduce muscle spasms. Cyclobenzaprine is one example of a muscle relaxant. These medications require a doctor’s prescription and are one of the common spinal stenosis treatment options.
• Anti-depressants: Some medications used to treat depression are also effective for relieving the pain of spinal stenosis. One example is venlafaxine. These medications require a doctor’s prescription.
• Anti-seizure drugs: Medications used to treat seizure disorders are also helpful in controlling pain caused by nerve disorders and can help control the pain caused by spinal stenosis. One example is gabapentin. Again, a physician’s prescription is needed for these types of drugs.
• Opioids: These are narcotic medications. These are usually only prescribed for very severely painful spinal stenosis, and they are given for limited amounts of time. An example of a narcotic is oxycodone. A doctor’s written prescription is needed to obtain opioids.
• Epidural Injections: Your physician may recommend epidural steroid injections as spinal stenosis treatment. The goal of these injections is to reduce the swelling and irritation directly in the affected area. Corticosteroids have anti-inflammatory properties and can help ease swelling and reduce the pressure caused by spinal stenosis. Because of the potential side effects of steroids, these injections can only be given a few times per year.

Spinal stenosis therapy

Sometimes, physical therapy for spinal stenosis is recommended for patients with one of the treatment options for this condition. A therapist can help with an exercise program that is designed to help:

• Improve the flexibility and stability of the spine
• Improve overall strength
• Improve and maintain balance

Spinal stenosis surgery

Surgery is not usually recommended unless conservative spinal stenosis treatment has been unsuccessful or the symptoms of spinal stenosis are so severe they are causing serious disability. The goal of spinal stenosis surgery is to decompress or remove the pressure from the spinal cord and nerve roots.

• Laminectomy: A common procedure for spinal stenosis is a laminectomy. A part of a vertebra is removed in this operation to create more room in the spinal canal. 
• Spinal fusion: If more stability is needed in the spine, a procedure called spinal fusion may be necessary. In this procedure for spinal stenosis, vertebrae are fused to form one solid piece of bone.

Spinal stenosis surgery usually helps ease the symptoms of the condition, but there are risks associated with any procedures on the spine. These may include:

• Infection
• Blood clots
• Neurological decline or deficit
• Leakage of spinal fluid
• Respiratory problems
• Bleeding

Home remedies for spinal stenosis

There are several home remedies for spinal stenosis that may help relieve the pain associated with the disorder:

• Take over-the-counter pain medications to help with inflammation and discomfort.
• Try applying cold packs or mild heat to painful areas.
• Consider using a walker or cane to help relieve spinal stenosis pain. These add stability and also allow you to take pressure off your spinal cord and nerves while walking.

If your pain is severe or you have weakness or numbness in your arms or legs, contact your doctor.