Nonsurgical treatment focuses on restoring function to the extremities and pain relief. Although nonsurgical methods do not improve the narrowing of the spinal canal, many patients report that such treatment helps to relieve manny of the symptoms.
Physical therapy: Stretching exercises, massage as well as lumbar and abdominal strengthening are used to help manage the noted symptoms.
Lumbar traction: Although helpful with select patients, traction delivers limited results. There is no scientific evidence of traction’s effectiveness in treatment.
Anti-inflammatory medications: Because stenosis pain is caused by pressure on a spinal nerve, reducing inflammation (swelling) around the nerve may relieve pain. Non-steroidal anti-inflammatory drugs (NSAIDs) provide initial pain relief. When used over the course of 5-10 days, they can also have an anti-inflammatory effect.
Most people are familiar with non-prescription NSAIDs, such as aspirin and ibuprofen. Whether over-the-counter or prescription strength, these medicines must be used carefully. In some cases, they can lead to gastritis or stomach ulcers. If you are planning to take NSAIDs or develop acid reflux or stomach pains as a result of taking any such anti-inflammatory, consult your physician immediately.
Steroid injections: Cortisone is a powerful anti-inflammatory drug. Cortisone injections around the nerves or in the “epidural space” can decrease swelling as well as pain. They can also reduce numbness, but not weakness, in the legs and lower extremities. Patients should receive no more than three injections in the course of a year.
Acupuncture: Acupuncture can be helpful in treating some of the pain for less severe cases of lumbar stenosis. Although it can be very safely administered, long-term efficacy of this treatment has not been proven scientifically.
Chiropractic manipulation: Chiropractic manipulation administered by a professional is generally considered safe and may help to alleviate some pain associated with lumbar stenosis. Care should be taken if a patient has osteoporosis or disk herniation as manipulation of the spine can worsen symptoms or cause other injuries in such cases.
Surgery for Spinal Stenosis is generally reserved for patients who experience poor or reduced quality of life due to enduring pain and general weakness. Patients may complain of difficulty walking for extended periods of time.
There are two main surgical options to treat lumbar spinal stenosis: laminectomy and spinal fusion. Both surgical options may result in long-term pain relief. Be sure to discuss the advantages and disadvantages of both surgical procedures with your doctor.
Laminectomy: This procedure involves removing the bone, bone spurs, and ligaments that are compressing the nerves. This procedure is also commonly referred to as “decompression.”
Spinal fusion: If arthritis has progressed to spinal instability, a combination of decompression and stabilization or spinal fusion may be recommended by your doctor.