Treatment FAQ

what is the treatment spinal stenosis

by Ms. Piper VonRueden DDS Published 3 years ago Updated 2 years ago
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Surgery to decompress the area of stenosis is the most definitive way to try to resolve symptoms of spinal stenosis. Research shows that spine surgeries result in fewer complications when done by highly experienced surgeons. Don't hesitate to ask about your surgeon's experience with spinal stenosis surgery.Oct 24, 2020

Medication

  • Foraminal Stenosis: Narrowing occurs in the small openings that allow nerve roots to exit the spinal column
  • Lateral Recess Stenosis: Narrowing occurs in the back of the spinal canal where the nerve roots initially branch off
  • Central Canal Stenosis: Narrowing occurs in the main spinal canal, which protects the spinal cord

Procedures

You can try:

  • Exercise. Just a 30-minute walk every other day can help. Talk over any new exercise plan with your doctor.
  • Heat and cold. Heat loosens up your muscles. …
  • Good posture. Stand up straight, sit on a supportive chair, and sleep on a firm mattress. …
  • Lose weight. Extra pounds put more pressure on your back.

Therapy

What happens when you don’t treat Spinal Stenosis?

  • Decreased Activity. You don’t want your life ruined by the effects of spinal stenosis. ...
  • Disability. In severe cases of stenosis, the patient may even become disabled. ...
  • Decrease or Loss of Bladder and Bowel Control. In extreme cases, spinal stenosis can also make the nerves connected to the bladder or bowel weak. ...
  • Consistent Pain and Discomfort. ...

Nutrition

  • Laminectomy. One or both laminae (the posterior, or back, part of the vertebra) are removed to provide more space for the compressed spinal cord and/or nerve roots. ...
  • Laminotomy. A part of or the entire lamina on one side of the affected vertebra is removed with or without adjacent tissues. ...
  • Foraminotomy. ...
  • Facetectomy. ...

See more

Which type of spinal stenosis do you need treated?

How do you treat spinal stenosis without surgery?

What are the long - term effects of spinal stenosis?

What type of surgery is performed to treat spinal stenosis?

See more

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What is the most common treatment for spinal stenosis?

Spinal stenosis is commonly treated with medication, both over-the-counter and prescription. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain and inflammation. Examples of over-the-counter NSAIDs include aspirin, naproxen (Aleve), and ibuprofen (Advil, Motrin).

What is the newest treatment for spinal stenosis?

A wide-reaching innovation, endoscopic spine surgery has the promise to transform the lives of patients with spinal stenosis, degenerative disc disease, and disc herniations. Endoscopic spine surgery has unleashed the new potential for faster, safer, and more effective surgical recoveries.

How do you fix spinal stenosis without surgery?

Nonsurgical Treatment Options for Spinal StenosisSteroid Injections. Epidural steroid injections are commonly used to provide long-term pain relief. ... DRX9000. ... Medication. ... Physical Therapy. ... Correcting Posture. ... Permanent Lifestyle Changes. ... Facet Blocks. ... Radiofrequency Ablation.

Can stenosis of the spine be cured?

Lumbar spinal stenosis is the narrowing of the spine that happens gradually over time. There is no cure for lumbar spinal stenosis but your healthcare provider can help you manage the condition.

What is the best doctor to treat spinal stenosis?

If your primary care doctor thinks you have spinal stenosis, he or she may refer you to a doctor who specializes in disorders of the nervous system (neurologist). Depending on the severity of your symptoms, you may also need to see a spinal surgeon (neurosurgeon, orthopedic surgeon).

What is the best sleeping position for spinal stenosis?

Many people with spinal stenosis find the most comfort sleeping on their side in “fetal position” — that is, with knees curled up toward the abdomen. Another alternative is to sleep in an adjustable bed or recliner that allows the head and knees to remain elevated.

Will a cortisone shot help spinal stenosis?

When epidural steroid injections are used. Epidural steroid injections may help relieve pain stemming from conditions such as spinal stenosis, foraminal stenosis, disc herniation, or degenerative disc disease.

What happens if you let spinal stenosis go untreated?

Rarely, untreated severe spinal stenosis may progress and cause permanent: Numbness. Weakness. Balance problems.

Can a chiropractor fix spinal stenosis?

If you or a loved one have spinal stenosis, you know how debilitating this condition can be. Here at The Chiropractic Doctors, our chiropractors have successfully helped many patients with spinal stenosis overcome their symptoms without the use of invasive surgery or harmful medications.

What should I avoid with spinal stenosis?

What Is Spinal Stenosis?Avoid Excessive Back Extension. ... Avoid Long Walks or Running. ... Avoid Certain Stretches and Poses. ... Avoid Loading a Rounded Back. ... Avoid Too Much Bed Rest. ... Avoid Contact Sports.

Can you live with spinal stenosis without surgery?

Can spinal stenosis be treated without surgery? Yes. In fact, less than 5% of patients with a spinal disorder ever require spine surgery. There is a wide variety of medications available to relieve inflammation, pain, and muscle spasm.

How do you prevent spinal stenosis from getting worse?

Having good posture and practicing proper body mechanics are some of the best ways to prevent stenosis from progressing and to ensure the health of your back. Good posture and body mechanics should be practiced all the time—whether you're sitting, standing, lifting a heavy object, or even sleeping.

What is next if epidural injection doesn't work?

An alternative to ESIs, or an option to consider if injections are no longer providing relief, is the mild® Procedure. mild® stands for minimally invasive lumbar decompression. It's a short outpatient procedure that relieves pressure on the spine through an incision smaller than the size of a baby aspirin (5.1 mm).

Does injection help spinal stenosis?

An epidural steroid injection (ESI) is a minimally invasive procedure that can help relieve neck, arm, back, and leg pain caused by inflamed spinal nerves due to spinal stenosis or disc herniation.

How do you prevent spinal stenosis from getting worse?

Having good posture and practicing proper body mechanics are some of the best ways to prevent stenosis from progressing and to ensure the health of your back. Good posture and body mechanics should be practiced all the time—whether you're sitting, standing, lifting a heavy object, or even sleeping.

What is the success rate of surgery for spinal stenosis?

Success Rates of Lumbar Laminectomy for Spinal Stenosis Research suggests: 85% to 90% of lumbar central spinal stenosis patients find relief from leg pain after an open laminectomy surgery. 75% of patients may have satisfactory outcomes for up to 10 years postoperatively.

Spinal Stenosis Fundamentals

With age, the spinal canal – located in the lower back – can narrow, resulting in spinal stenosis. The narrowing process, which is gradual, reduces...

What Causes Spinal Stenosis?

Spinal stenosis occurs when bulging discs, arthritic spurs, and thickened tissues combine to "compress" the nerves traveling through the spinal can...

What Are Treatment Options For Spinal Stenosis?

Medical Treatment 1. Taking non-steroidal anti-inflammatory drugs (NSAIDs) for relief. 2. Receiving cortisone injections directly into the spinal c...

How Do I Prepare For Spinal Stenosis Surgery?

To prepare for spine surgery, quit smoking if you smoke, exercise on a regular basis to improve your recovery rate, stop taking any non-essential m...

What Happens After Spinal Surgery?

Pain may persist for a few days after surgery, requiring the use of pain medications and NSAIDs to reduce swelling. However, your doctor will likel...

How Long Is The Recovery Period After Surgery?

Full recovery after surgery for spinal stenosis typically takes three months and possibly longer for spinal fusion, depending partially on the pati...

What Is The Rehab After Spinal Stenosis Surgery?

After spine surgery, your doctor will likely prescribe walking and strengthening exercises for the lower back and abdomen to help stabilize the spine.

What Are The CCF Physician credentials?

1. All doctors at Cleveland Clinic Center for Spine Health are fellowship-trained and board-certified or board-eligible in orthopaedic surgery, med...

What Clinical Trials Are Being Conducted at CCF on Spinal Stenosis?

Researchers at Cleveland Clinic are involved in ongoing studies that investigate new drugs and treatment approaches for managing disease. Participa...

Are There Other Resources That I Can Go to For More Information on Spinal Stenosis?

Patients can go to the following resources for more information on this procedure: 1. Cleveland Clinic Health Information Center 2. American Academ...

What is spinal fusion?

Spinal fusion: This procedure is considered if you have radiating nerve pain from spinal stenosis, your spine is not stable and you have not been helped with other methods. Spinal fusion surgery permanently joins (fuses) two vertebrae together.

What does it mean when your butt hurts?

This is pain that begins in the buttocks and extends down the leg and may continue into your foot. A heavy feeling in the legs, which may lead to cramping in one or both legs. Numbness or tingling (“pins and needles”) in the buttocks, leg or foot. Weakness in the leg or foot (as the stenosis worsens).

What causes low back pain and sciatica?

Spinal stenosis has many causes. What they share in common is that they change the structure of the spine, causing a narrowing of the space around your spinal cord and nerves roots that exit through the spine. The spinal cord and/or nerve roots become compressed or pinched, which causes symptoms, such as low back pain and sciatica.

What does it feel like to have stenosis in your back?

Depending on where and how severe your spinal stenosis is, you might feel pain, numbing, tingling and/or weakness in your neck, back, arms, legs, hands or feet. Normal spine with no narrowing of the space around the spinal cord or nerve roots exiting the spinal column. Cleveland Clinic is a non-profit academic medical center.

How do you know if you have spinal stenosis?

First, spinal stenosis develops slowly over time, so you may not have symptoms even though changes are occurring in your spine. Your first noticeable symptoms may be pain, numbness, tingling or weakness in your back or neck or arms and legs depending on the location of the stenosis.

What are the symptoms of lumbar canal stenosis?

Symptoms of lumbar canal stenosis include pain, numbness or weakness in the legs, groin, hips, buttocks, and lower back. Symptoms usually worsen when walking or standing and might decrease when lying down, sitting, or leaning slightly forward. Cleveland Clinic is a non-profit academic medical center.

What is the procedure for lumbar spinal stenosis?

The procedure involves removing bone or tissue this area to provide more space for the nerve roots. Interspinous process spaces: This is a minimally invasive surgery for some people with lumbar spinal stenosis.

How to get rid of stenosis in the spine?

Spinal stenosis exercises. Exercise, along with good eating habits, can help you slim down if you’re overweight. This will ease the strain on your spine. Even if you do decide to have surgery, exercising afterward can boost your recovery. But you’ll need to start slowly.

What is spinal stenosis?

What Are the Treatments for Spinal Stenosis? Spinal stenosis is a narrowing of the canal in your spinal column that affects mostly people age 50 and older. Nothing can cure it, but there are things you can do on your own, under your doctor's guidance, to enjoy an active life.

How long does it take to recover from spinal fusion?

Recovery can be a few days or up to 3 months. Surgery helps many people but there are also risks, such as blood clots.

What to do if your spine doesn't work?

Surgery for Spinal Stenosis. If these treatments don't work, your doctor may suggest surgery, especially if: You're in a lot of pain. You have trouble walking. You can't control your bladder. In fact, your doctor may recommend surgery first if you have severe symptoms.

What is the procedure called when you have a hole in your neck?

The hole should be just big enough to relieve some pressure in the area. Laminoplasty. This procedure creates space in the spinal canal in your neck. A metal hinge is put on the lamina to bridge the gap of the opened-up area.

What is the procedure to remove a bulging disc?

Discectomy. With this procedure, the injured part of a bulging, or herniated, disc is taken out to ease pressure on your nerves or spinal cord. It can be done through a cut in your spine or neck that lets your doctor get to it directly or with smaller cuts and tiny instruments. Spinal fusion.

What are some exercises to help with pain?

Boost your fitness: Aerobic exercises, ones that get your heart and breathing rates up, release chemicals called endorphins that can ease pain. Examples of aerobic exercise include bicycling or swimming. There's no one right way to exercise with this condition -- and you don’t want to overdo it.

How long does a massage help with spinal stenosis?

One study found that weekly massage over a ten-week period provided pain relief for up to six months.

What is the procedure called for spinal stenosis?

Vertiflex procedure for spinal stenosis. The Vertiflex procedure for spinal stenosis (also called the Superion® implant) is a new way to increase the space between the vertebrae — space that may collapse as spinal stenosis progresses.

What is spinal stenosis?

Spinal stenosis is a narrowing of the spine that occurs most often in the lower back ( but can also occur in the cervical spine). This narrowing eventually begins to crowd the spinal cord and nerves in the spinal column. When this happens, radiating pain and mobility issues can quickly follow.

What is the term for a swollen arm and a tingling sensation in the lower back?

Radiating pain (called sciatica when it occurs in the lower back) Numbness or tingling in the arms, hands, legs, or feet. Weakness in the extremities. Neck pain (in cervical spinal stenosis) Clumsiness in the arms and hands (in cervical spinal stenosis)

How many people have spinal stenosis?

Spinal stenosis is a pain condition that affects an estimated 500,000 people in the U.S. While some cases are mild and have little impact on daily life, other people experience debilitating pain and limited mobility. If you or someone you love is suffering, these are some of the best treatments for spinal stenosis.

How to help stenosis?

Stretches. Targeted spinal stenosis exercises can help lengthen the spine and relieve pressure on your nerves. Flexion exercises in particular decreased pain and lowered the risk of disability in people with spinal stenosis. Core stability stretches and exercises also resulted in an increase in walking capacity.

What is the difference between cervical spinal stenosis and foraminotomy?

Laminoplasty: Laminoplasty is for cervical spinal stenosis, removing part of the bone and inserting plates and screws to maintain space. Foraminotomy: Nerve roots exit the vertebra through the foramen, and this surgery removes bone to make more space there.

Spinal Stenosis Treatment: Why Choose Johns Hopkins

Our spine specialists treat a variety of spinal stenosis conditions, including cervical, lumbar and thoracic spinal stenosis and multilevel spinal stenosis.

Surgical Options

If nonsurgical treatments don’t provide sufficient relief, surgery may be necessary to remove tissues that are pressing on the spinal cord or nerve roots. These tissues may include all or parts of intervertebral discs, vertebrae, facet joints or hardened ligaments.

What are the nonsurgical treatments for spinal stenosis?

Other nonsurgical treatments for spinal stenosis symptoms include: Physical therapy for strength and flexibility. Spinal manipulation by a physical therapist or chiropractor. Acupuncture. Massage. Surgery to treat spinal stenosis includes: Laminectomy. Most frequently used surgical procedure for lumbar spinal stenosis.

How is spinal stenosis treated?

Spinal stenosis is treated with medications, lifestyle options, and surgery. Medications used to treat spinal stenosis symptoms include: Other nonsurgical treatments for spinal stenosis symptoms include: Implantation of a device between the spinous processes at one or two vertebral levels, relieving compression.

What is spinal stenosis?

Spinal stenosis is a narrowing of the spaces in the spinal canal, which is the space that contains the vertebrae, spinal cord, spinal discs, nerves, and other tissues . The narrowing is typically caused by arthritis or injury.

What are the symptoms of Cauda equine syndrome?

Symptoms of severe cases of spinal stenosis (cauda equine syndrome) that require immediate medical attention include: Severe pain and weakness spreading into one or both legs that cause difficulty walking or getting up from a chair.

What is the procedure for lumbar spinal stenosis?

Most frequently used surgical procedure for lumbar spinal stenosis. Removes part or all of one or both lamina of the vertebra at the involved level. Intraspinous spacer implantation. Less invasive treatment option. Implantation of a device between the spinous processes at one or two vertebral levels, relieving compression.

What does it mean when your foot slaps down?

Loss of sensation in the feet. Foot weakness that causes the foot to slap down when walking (foot drop) Loss of sexual ability. Symptoms usually worsen when walking or standing upright and improve when sitting or bending forward at the waist.

Can osteoarthritis cause spinal stenosis?

Most people develop some osteoarthritis -- the main cause of spinal stenosis -- as they age, which is why spinal stenosis is most common among adults over age 50. However, you may be able to lower the risk of developing symptoms of spinal stenosis by keeping the spine healthy.

What is the best treatment for lumbar spinal stenosis?

The following drugs are commonly used to treat lumbar spinal stenosis pain: Nonsteroidal anti-inflammatory drugs (NSAIDs). Medications such as ibuprofen and naproxen may be used to temporarily relieve stenosis pain.

What is the best medication for spinal stenosis?

Medications such as ibuprofen and naproxen may be used to temporarily relieve stenosis pain. These drugs are used with caution due to gastrointestinal side effects in the long-term. 3. Gabapentinoids. The antiepileptic medications gabapentin and pregabalin may help inhibit nerve pain caused by spinal stenosis. 2.

How to relieve lumbar spinal stenosis pain?

Injections help relieve lumbar spinal stenosis pain by achieving the following goals: Reduce spinal inflammation . Stop or inhibit the transmission of pain signals from the spine to the brain. Injections may be delivered in the epidural space (space surrounding the spinal cord) or directly on or around the target nerve.

How much pain does lumbar stenosis relieve?

Research indicates that 60% to 90% of patients experience relief of symptoms after nonsurgical or surgical treatment for lumbar spinal stenosis. 1 Treatment usually relieves leg pain more than back pain. Back pain may continue to persist even after treatment if pre-existing degenerative arthritis is present. 1

How to help stenosis pain?

Physical therapy and exercise help relieve spinal stenosis pain in the following ways: Provides symptom relief. Restores function of the lumbar spine and the sacroiliac joint. Improves mobility of the lower body. Fosters a better healing environment in the lower back. Prevents pain recurrence and flareup.

How to treat lumbar stenosis?

Treatment of stenosis in the lumbar spine depends on the specific cause. While stenosis caused by a herniated disc may be treated with physical therapy and exercise , large overgrown bony protrusions from the facets may require surgical trimming.

How to reduce stress on spinal cord?

Walking with support by leaning forward on a cane, walker, or shopping cart. Avoiding extended periods of standing. Placing one foot over a step stool if standing for a long time, such as while doing dishes or cooking. Maintaining a healthy weight to reduce stresses on the spinal and pelvic joints.

Why do doctors recommend surgery for spinal stenosis?

In severe cases of spinal stenosis, doctors may recommend surgery to create additional space for the spinal cord or nerves.

Why does my spine tingle?

Symptoms can worsen over time. Spinal stenosis is most commonly caused by wear-and-tear changes in the spine related to osteoarthritis. In severe cases of spinal stenosis, doctors may recommend surgery to create additional space for the spinal cord or nerves.

What age can you get spinal stenosis?

Most people with spinal stenosis are over the age of 50. Though degenerative changes can cause spinal stenosis in younger people, other causes need to be considered. These include trauma, congenital spinal deformity such as scoliosis, and a genetic disease affecting bone and muscle development throughout the body.

Why do some people have a small spinal canal?

But most spinal stenosis occurs when something happens to narrow the open space within the spine. Causes of spinal stenosis may include: Overgrowth of bone.

What are the problems with herniated disks?

As your spine ages, it's more likely to experience bone spurs or herniated disks. These problems can reduce the amount of space available for your spinal cord and the nerves that branch off it.

Where does the narrowing occur?

In this condition, the narrowing occurs in the part of the spine in your neck. Lumbar stenosis. In this condition, the narrowing occurs in the part of the spine in your lower back. It's the most common form of spinal stenosis.

Where do abnormal growths form?

Abnormal growths can form inside the spinal cord, within the membranes that cover the spinal cord or in the space between the spinal cord and vertebrae. These are uncommon and identifiable on spine imaging with an MRI or CT. Spinal injuries.

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Diagnosis

Clinical Trials

Lifestyle and Home Remedies

Preparing For Your Appointment

Medically reviewed by
Dr. Karthikeya T M
Your provider will work with you to develop a care plan that may include one or more of these treatment options.
Treatment options for spinal stenosis include: Medication, physical therapy and surgery. Surgical procedures are opted if the pain is severe and there are any neurological problems.
Medication

Analgesics: Reduce pain.

Ibuprofen . Naproxen . Acetaminophen


Antidepressants: Ease chronic pain.

Doxepin . Clomipramine


Anti-seizure medication: Reduce pain caused by damaged nerve.

Gabapentin . Pregabalin


Opioids: For short time pain relief.

Oxycodone . Hydrocodone


Steroid injections: Prevent swelling.

Betamethasone

Procedures

Laminectomy: Part of the vertebrae is removed and more space is provided for the nerves.

Foraminotomy: This is a procedure to widen the passageway where the spinal nerve root exits the spinal canal.

Spinal fusion: Bone grafts or metal implants are used to attach the affected bones of the spine together.

Therapy

Physical therapy:To maintain flexibility and build up strength.

Nutrition

Foods to eat:

  • Foods to stay hydrated
  • Eat plenty of fruits and vegetables
  • Carbohydrates and fat
  • Protein
  • Vitamin and minerals
  • Soy-based food and beverages

Foods to avoid:

  • Red meat
  • Caffeine
  • Alcohol

Specialist to consult

Neurologist
Specializes in treating diseases of the nervous system, which includes the brain, the spinal cord, and the nerves.
Neurosurgeon
Specializes in surgery on the nervous system, especially the brain and spinal cord.
Spinal surgeon
Specializes in the treatment of spinal diseases and conditions through surgical procedures.
Orthopedic surgeon
Specializes in the surgery of bone and joint disorders.

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