- Diseases, Disorders & Conditions
Spinal Stenosis Treatment--The Different Methods of Treating Spinal Stenosis
The goal of a spinal stenosis treatment is to relieve pain, numbness, and weakness in the lower back and the legs, as well as improve the overall quality of life. Spinal stenosis is the narrowing of the spinal canal that usually starts gradually and develops over a long period of time. As the spinal canal narrows, it can compress the spinal cord or the nerve roots that branch out from the spinal cord. or it can squeeze and irritate the spinal cord itself. Spinal stenosis treatments include physical therapy, exercises, pain-relieving medicine, other nonsurgical measures, and surgical procedures.
Diagnosis of spinal stenosis
Treatment of spinal stenosis begins with a diagnoses. In order to make
a proper diagnoses of spinal stenosis, a physician has to make a
complete evaluation of the spine. This is typically done by reviewing
the patient's personal and family medical history as well as physical
examination. Medical history will tell the doctor the patient's
symptoms, possible causes of back pain, and ultimately the cause for
Physical examinations determines exactly where the nerve compressions are. Visual exams are often performed via x-ray and other imaging mediums. The x-ray will reveal the spinal vertabrae, and is helpful for finding issues such as arthritis, traumatic injury, tumors, or any other abnormalities. A myelogram, which is an x-ray of dye injected into the spinal fluid, may also be used.
Other imaging mediums used for physical exams include a magnetic resonance imaging (MRI) scan, computed tomography (CAT) scan, and a bone scan. A CAT scan is similar to the x-ray, but shows more detail of the tissues of the body. An MRI uses magnetic symbols to show images of the spine, nerves, ligaments, and muscles. A bone scan involves injection of radioactive material into the veins, which flows areas of high bone activity.
Spinal stenosis therapy treatments
Once a diagnosis is determined, the physician determines the best
treatment for spinal stenosis. Unless a spinal stenosis condition is
severe, the initial treatments are designed to provide relief without
performing surgery. In fact, most cases of spinal stenosis do not
Physical therapy is most commonly used to help the patient learn stretch and strengthening exercises that can help relieve symptoms and slow down the progression of stenosis. Better support and condition of the spine also helps to alleviate nerve compression.
In addition to stretching and strengthening exercises, aerobic exercise is also encouraged. If a patient is overweight, then weight loss is encouraged to help relieve pain. Usually losing ten pounds or more is sufficient to make a significant improvement of the condition.
Medications for spinal stenosis
Sometimes medications are used to relieve stenosis pain. These medications may include:
- Nonsteroidal Anti-Inflammatory Medications (NSAIDs)
NSAIDs are commonly prescribe to help relieve spinal stenosis pain. NSAIDs help to reduce inflammation, which helps to alleviate pressure on compressed nerves.
- Oral Steroid Medications
Oral steroid medications are usually helpful for episodes of an acute symptoms. Medications used include Prednisone and Medrol. Like NSAIDs, oral steroids are anti-inflammatory medications relieving compressed nerves.
- Epidural /Cortisone Steroid Injections
Sometimes, injections of cortisone are administered directly in the area of compression. Like the oral anti-inflammatory medications, steroids injections help to relieve compression on the nerves. When the injection is used, the medication is directly delivered to the area of the spinal stenosis. Steroid injections are usually only used to treat symptoms of lumbar spinal stenosis that occur in the legs. This treatment only relieves symptoms for a short time, and the long-term effects are currently unknown.
Alternative spinal stenosis treatments
An alternative stenosis treatment may include massage therapy, acupuncture/acupressure, magnetic therapy, herbal remedies, and other modalities of Eastern medicine.
Spinal stenosis surgery
Spine surgery is the riskiest lumbar spinal stenosis treatment and is usually only considered for severe cases or if all other treatment methods fail to alleviate the symptoms. Spinal stenosis surgery involves the removal of excess soft-tissue, bone, and ligament for decompression of the nerves. When surgery is performed for spinal stenosis, the nerves are decompressed. This means that excess bone, ligament, and soft-tissue is removed to The procedure performed depends on precisely where the compression is taking place. Depending on what tissue is removed, the procedure may be called a laminectomy (removal of the bone behind the spinal cord), foramenotomy (removing bone around the spinal nerve), or a discectomy (removing the spinal disc to relieve pressure).
Depending on the extent of the spinal stenosis, spinal fusion surgery may be performed to correct problems with instabilities of the spine.
Possible complications of spinal stenosis surgery include :
- Tears in the dural sac surrounding the spinal cord
- Instability of the spine
- Worsening of arthritis.