Stenosis is the abnormal narrowing of a passage in your body, therefore spinal stenosis is the narrowing of your spinal canal (central stenosis) or nerve root canal (lateral stenosis). Because your spinal canal houses the spinal cord, this narrowing affects your spinal cord and all the nerves in it. The reduced space for your nerves causes pain, cramping, numbness or weakness in your legs, back, neck or arms.
While there’s no treatment available to completely cure spinal stenosis symptoms, there are many ways for you to manage your condition. Depending on the severity and location of your spinal stenosis, the best treatment will vary. The first step in treating spinal stenosis is attempting non-surgical treatment. The following options are non-surgical treatments recommended for mild symptoms:
Self-Care
Sometimes making small adjustments in a daily routine can reduce your symptoms. Your lower back bears most of your weight, so it’s worthwhile to adjust the way you walk, sit, sleep or stand to maintain alignment. The following steps might help reduce your pain:
Take a warm bath or use a heating pad
Heat stimulates the senses in the area it’s applied to which reduces the amount of pain signals being sent to the brain. Heat therapy also opens up the blood vessels in the area, allowing for a greater flow of oxygen and nutrients to the area. This can increase healing.
Change your sleeping position
If you notice an increase in pain after a night of sleep, you might try adjusting your sleep position. If you’re most comfortable sleeping on your side, try putting a pillow between your knees to allow your spine to remain in proper alignment. If you’re most comfortable sleeping on your back, place a pillow underneath your knees to create a more inviting position.
Create a more supportive work station
If you have a desk job, consider making a few changes in your office to reduce the stress placed on your spine. You can roll up a towel and place it between your lower back and chair to allow better support for your lower back. If you have a more physical job, try taking a break twice every hour to help your body recover from repetitive movement.
Physical Therapy
Working with a physical therapist is useful for strengthening your body and supporting your return back into normal activities. Your physical therapist may instruct you on proper posture and walking techniques to reduce stress on your lower back. They may also recommend exercises that will strengthen your back, leg and stomach muscles to help improve your posture. Continue the exercises done with your physical therapist at home for sustained relief of symptoms.
Medication
There are various medications that can be used to reduce spinal stenosis pain. These include:
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) reduce inflammation by blocking certain chemicals in the body that cause inflammation. Because spinal stenosis pain can be caused by inflammation in the spine, NSAIDs are particularly helpful in relieving pain. NSAIDs include aspirin, naproxen (Aleve, Naprosyn), and ibuprofen (Motrin, Nuprin, Advil).
- Analgesics (pain relievers) can provide temporary pain relief by preventing damaged cells from producing chemicals called prostaglandins. When these chemicals are picked up by nerves, pain signals are sent to the brain. While these medications can be effective at reducing pain, they do not reduce inflammation. Analgesics include medications like Tylenol.
- Steroids can be prescribed to people with spinal stenosis to reduce symptoms. Steroids reduce the production of chemicals that cause inflammation. This reduces the pain caused by the inflammation in your spine. Your doctor will most likely prescribe these as an oral medication to take over a five-day period. You can also receive steroid injections (see below).
- Antidepressants can help reduce your chronic pain. The mechanism by which these medications decrease pain isn’t completely understood, however it’s thought that antidepressants increase the level of neurotransmitters in your spine that reduce pain. To see the pain reducing effects of antidepressants, you must take them daily over weeks.
- Anti-seizure drugs decrease pain caused by damaged nerves. Because spinal stenosis is causes by the pinching of nerves, these can be highly effective in reducing symptoms. These include gabapentin (Neurontin) and pregabalin (Lyrica).
- Opioids are drugs that block pain messages from being received in the brain. As opioids are highly addictive, they are typically only prescribed in the short term.
Steroid Injections
Steroid injections deliver pain relief medication directly into the place of swelling and inflammation. These are done through a minimally invasive procedure that injects the medicine into your spine. You’ll be given a numbing agent prior to the procedure and shouldn’t experience pain. It’s recommended that the use of steroid injections is repeated over the course of a few months. You should note that frequent or excessive steroid injections can cause weakened bones and connective tissues. Because of this, these injections should be done along with physical therapy or a home exercise program approved by your doctor in order to keep back muscles strong. There are two main types of injections to treat spinal stenosis:
Epidural Steroid Injections: A mixture of steroids and numbing agent is injected into the epidural space of your spinal canal or nerve root canals. The epidural space is the area in between the vertebrae and the spinal cord. As the medication is injected directly into the area where the pain is starting, this can be effective at reducing the swelling and inflammation associated with spinal stenosis.
Facet Injections: A mixture of steroids and numbing agent is injected into the facet joint or the nerves surrounding it. Similar to epidural steroid injections, facet injections reduce pain by decreasing inflammation in the area.
Note: The effect of steroid injections is highly variable. Some people feel pain relief within days, some within weeks, and some never feel any difference in their pain after receiving these injections.
Chiropractic Treatment
A chiropractor uses their hands to apply a sudden force on your spinal joints. This can manipulate your spine in such a way that it improves your mobility and functioning. This realignment can reduce pain or tightness in your back in addition to improving your movement. You should not receive chiropractic treatment if you have severe osteoporosis, as this increases your chance of a bone fracture.
Disclaimer – All information is for educational pursuit and information purposes only. It is not intended nor implied to be a substitute for professional medical advice. The viewer should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding their medical condition, diagnosis, procedures, treatment plan, or other health related topics.