Spinal Stenosis Treatments
Spinal stenosis treatment — conservative, alternative and surgical options
Patients who are diagnosed with spinal stenosis have a multitude of treatment options to choose from that can be used to alleviate the pain and discomfort associated with the condition. Spinal stenosis is a narrowing of the spinal canal in the cervical, thoracic or lumbar spinal regions. The spine provides a framework to protect the spinal cord and allow its nerve roots to branch off and serve other areas of the body. When the channels through which your spinal cord and nerve roots travel become narrower, nerve tissue can be squeezed or compressed. Spinal stenosis treatment usually focuses solely on reducing symptoms, but in more extreme cases, treatments may involve surgery to reduce the compression of the spinal cord and its nerve roots.
Spinal stenosis treatment addresses the symptoms
Spinal stenosis, if not properly diagnosed or treated, can lead to recurring pain that may limit your daily activities, such as the ability to work, travel or exercise. The pain of this condition can radiate from your neck or back to your shoulders, arms, hips, legs and feet. You may also experience numbness, weakness or a tingling sensation. Some flexibility may be lost, and there can be discomfort when sitting or leaning backward.
Patients may experience varying symptoms, and therefore require different forms of spinal stenosis treatment. This is primarily due to the fact that complications differ based on the part of the spine in which the narrowing occurs. For instance:
- If spinal stenosis develops in the top (cervical) part of the spine, symptoms may be felt in the neck and the upper extremities, including the shoulders, arms, hands and fingers.
- If stenosis develops in the central (thoracic) part of the spine, the symptoms may be felt in the torso, or the part of the back behind the ribcage.
- If stenosis develops in the lower (lumbar) part of the spine, symptoms may be felt in the lower back and the lower extremities, including the buttocks, hips, legs and feet.
When spinal stenosis compresses a nerve root and symptoms “radiate” along the corresponding nerve path, it can cause a complication known as radiculopathy. Sciatica is a specific type of radiculopathy, and perhaps the most common example. This condition can occur if spinal stenosis compresses the sciatic nerve, and is characterized by pain that radiates downward from the buttocks to the feet, as well as tingling and numbness that travel along the same nerve path. However, the sciatic nerve is just one of the nerves that can be compressed by spinal narrowing.
The same way that nerve compression can cause radiculopathy, spinal cord compression can cause a complication known as myelopathy. This can bring about a collection of other symptoms, including a heavy feeling in the legs, an inability to walk at a quick pace, a deterioration of fine motor skills and coordination and intermittent shooting pains that run through the extremities.
Each patient’s spinal stenosis treatment plan will depend on the specific symptoms he or she is experiencing. If you believe your neck or back pain is due to spinal stenosis, contact your health care provider. He or she will be able to make a proper diagnosis by conducting a physical and neurological examination, and possibly order a CT scan or MRI. These tests will help your health care provider determine the best recommendations for treatment.
Conservative and alternative spinal stenosis treatment options
In most cases, physicians tend to recommend conservative therapies for the first few months of spinal stenosis treatment. These options may include:
- Over the counter medications – Acetaminophen, ibuprofen and other medications can help relieve pain and inflammation. Relief can last for several hours at a time, but your physician can help you determine a dosing regimen that is best for your specific needs.
- Prescription medications – Although over-the-counter medications are often sufficient, prescription versions may be recommended if you have more severe or persistent symptoms.
- Activity modification – As simple as it sounds, avoiding activities that make your back pain worse can make a significant difference in your quality of life. Intermittent periods of rest can also provide respite from your spinal stenosis symptoms.
- Heat therapy, cold therapy or both – Applying heat or ice to the area (or alternating between the two) can aid with local pain control. Heat can relax tense muscles in the targeted area, while cold helps reduce swelling and inflammation. This spinal stenosis treatment can be repeated as necessary.
- Neck or back bracing – A neck or back brace can help hold your spine steady and restrict painful movements.
- Epidural steroid injections – A combination of numbing agents and corticosteroids can be injected directly into the epidural space of the spine, providing longer-term pain relief benefits. Some patients notice a significant improvement after just one injection, although other patients require a series of injections to obtain more meaningful relief.
- Physical therapy – As part of a spinal stenosis treatment plan, you may be instructed to attend one-on-one sessions with a physical therapist. These sessions can have several goals: to strengthen the muscles in your neck and back, to enhance your flexibility, to improve your posture or to improve your overall strength and conditioning. Individual exercises may also be prescribed so that you can continue working toward these goals on your own.
- Exercise regimens – In addition to physical therapy, low-impact exercises such as walking or swimming can help improve your overall health and perhaps reduce your spinal stenosis symptoms.
- Lifestyle changes – Although smoking and carrying excess weight aren’t direct causes of spinal stenosis, treatment recommendations can include tobacco cessation programs and weight loss, when applicable. Increasing fruit and vegetable consumption is another way that you can help improve your overall health while in treatment for spinal stenosis.
In some cases, however, conservative treatments do not provide meaningful, long-term results. When this occurs, patients should consider the minimally invasive spinal stenosis surgeries offered by Laser Spine Institute. Our procedures involve smaller incisions than traditional open neck or back procedures and are performed on an outpatient basis. Contact us today for a review of your MRI scan, and to learn more about our approach to minimally invasive, outpatient spinal stenosis treatment.