Treatment & Therapy of Spinal Stenosis
by Brad McHargue
Spinal stenosis is a condition that typically occurs as you age. It occurs when the spine begins to narrow in some areas. This can place unwanted pressure on nerves or the spinal cord, resulting in a myriad of symptoms. In most cases the symptoms are mild enough to warrant moderate treatment, but in some cases the condition may be severe enough to warrant surgery.
In some cases, symptoms may not develop. If they do, they vary depending on the cause of the compression and typically include pain in the legs, often accompanied by cramping, specifically while standing straight; pain that radiates down the back and through the hip; pain in the shoulders and neck, which can be accompanied by headaches and muscle weakness; problems related to balance; and cauda equina syndrome, which occurs when the nerves associated with the bladder and bowel become damaged, resulting in incontinence. If you experience any of these symptoms, consult with a physician immediately.
Spinal stenosis is typically mild enough to warrant only conservative action. Symptoms such as mild pain can usually be treated with over-the-counter medications such as non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs can help control pain as well as inflammation. In conjunction with this, your doctor may recommend physical therapy to help strengthen the back, which according to the Mayo Clinic helps keep the spine stable and flexible.
One of the best ways to treat the condition is simple bed rest and mild to moderate exercise that is considered low-impact. This includes walking or cycling. Some patients may benefit from a back brace to help keep the spine stable, while more serious cases may require injections of corticosteroids directly into the spinal fluid to help control pain and inflammation. All of these options should be explored before considering surgery.
If you decide to undergo surgery, you will most likely undergo a laminectomy, which involves removal of all or some of the lamina. The lamina are part of the spine and comprise the part of the bone in the back that rests over the spinal canal. This procedure allows more space for the nerves and allows easier access to anything that may be causing the compression, such as a herniated disk or a bone spur. According to Medline Plus, if the condition occurs as a result of the narrowing of the neural foramen, which is the opening in the spinal column that nerves run through, a procedure known as foraminotomy may be used to widen it and provide relief.
At times your doctor may perform a spinal fusion, which involves joining two spinal bones, or vertebrae, together. It is most often used when one vertebra slides on top of the one below it.
All of these surgeries come with inherent risks, such as infection and blood clots, and the surgery is not guaranteed to eliminate the pain entirely.