What is the best treatment for spinal stenosis?

Spinal stenosis treatment options

What is the best treatment for spinal stenosis?

What activities should be avoided with spinal stenosis?

Does acupuncture help spinal stenosis?

Can spinal stenosis be reversed?

Diagnosis and treatment

After a physical examination, your doctor will likely want to order some tests to determine the cause of your symptoms. Imaging tests, such as X-rays, MRI scans, and CT scans can provide detailed pictures of your spine.

There is no cure for spinal stenosis, but there are treatments to help relieve symptoms. Over-the-counter anti-inflammatory medications can ease swelling and pain. If they don’t do the trick, your doctor can prescribe higher-dose medication.

Your doctor may also recommend cortisone injections. This anti-inflammatory drug is injected directly into the area of the spinal stenosis. Cortisone can significantly ease inflammation and pain. Its effects may be temporary, however, and you shouldn’t have more than three injections in a single year.

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Exercise and Physical therapy

They can go a long way toward easing your symptoms and can also help with:

• Flexibility
• Balance
• Endurance

Medications

Spinal stenosis is commonly treated with medication, both over-the-counter and prescription.

Injections

Certain injections have the same effect as many medications. Doctors use 2 basic types for spinal stenosis:

Corticosteroids: These can be injected straight into the area around the spinal cord. This is called an epidural injection.steroids work on inflammation and pain. An anesthesiologist or other specialist administers the injection.

Nerve blocks: These are anesthetics injected near the damaged nerves.

Everybody responds differently to these injections. You may get relief for a long time, for a short period, or not at all.

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Alternative Treatments

The 2 most common alternative therapies are acupuncture and chiropractic treatment.

Acupuncture: This is a traditional Chinese practice in which someone inserts tiny, flexible needles into you or puts pressure on specific parts of your body to ease pain.

Chiropractic care: Chiropractors try to adjust your spine to reduce pain and improve movement. Some also use traction, which involves pulling bones further apart to make more room for the nerves. Although there isn't a lot of scientific evidence for this, some people say that traction helps them.

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Surgery

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. Like other treatments, surgery is not a cure, but it can help with pain and function.

What is the best treatment for spinal stenosis?

Taking non-steroidal anti-inflammatory drugs (NSAIDs) for relief. Receiving cortisone injections directly into the spinal column to provide short-term relief. Engaging in exercise and physical therapy that focuses on strengthening the back and abdominal muscles as well as stretching.

What activities should be avoided with spinal stenosis?

1. Avoid stretching in a standing position and extension stretches.

Thanks to the simple force of gravity, doing stretches while standing up puts unnecessary stress on your spine. If you have lumbar spinal stenosis, your spinal cord already has extra pressure on it from the narrowing canal; stretching in a standing position adds to it.

Also, avoid doing extension stretches (those where you bend backwards). These exercises are often done to increase flexibility but for those with spinal stenosis, the backwards position collapses the spinal canal even more, which could potentially exacerbate your symptoms.

Instead, try stretching while laying down.

When you stretch sitting down, you won’t be putting any additional stress on your spine. Knee stretches, in particular, are safe for those with spinal stenosis. To do knee stretches, lie on your back and gently pull one bent knee up to your chest. Hold it for a few seconds, then slowly return the bent leg to the floor. Repeat with your other leg. Then bring both knees up to your chest together, hold for a few seconds, and release both legs. These types of flexion exercises opens up the canal and may even help to relieve the symptoms of stenosis somewhat.

2. Avoid doing free weights.

Putting a weight bar across your shoulders and doing squats or doing any other type of weight lifting compresses your spine. That means the discs in between your vertebrae flatten somewhat, which can also lead to further compression on the nearby nerves. And while our bodies are generally built to handle compression to a certain degree, this type of exercise isn’t beneficial for someone with spinal stenosis.

Instead, try using a weight machine.

A weight machine is designed to support your body while you’re working out a specific muscle group. So while you’re lifting weights to strengthen your arms or legs, the machine is helping to stabilize your back (as long as you’re using it properly). That helps reduce potential issues for stenosis patients who are weight-lifting. Sitting while weight lifting is also not as traumatic for your back generally, because the forces placed upon your spine are reduced.

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3. Avoid running and similar high-impact exercises.

Pounding your feet on a hard surface for a length of time increases the compressive load on your spine. So if you have spinal stenosis, this type of repetitive impact will very likely irritate your spinal stenosis. And for those who are wondering whether walking helps spinal stenosis, the answer is...not really. While it’s always beneficial to keep moving, long walks on a hard surface can put the same kind of stress on your back that running can, and may cause your pain to flare up.

Instead, try swimming, cycling, or an elliptical machine.

Activities like these give your metabolism a boost (which helps you burn more calories) but are much easier on your spine than running or walking. Swimming is particularly ideal for spinal stenosis patients because it works a broad range of muscles and allows you to stretch and exercise simultaneously all in the gentle, non-weight-bearing environment of water. You can also try water walking, both forward and backward, in chest-high water. You’ll get a great workout without any damaging impact to your spine.

What about cervical stenosis? What exercises should you avoid?

If your stenosis is located in the neck, avoid doing arm-strengthening exercises that involve lifting weights up over your head. This put a huge strain on the discs in your neck and could make your condition worse. You should also avoid any exercise that moves your head in a circular pattern (like a neck roll) or that involve excessive flexion of the neck. All place undue pressure on an area of your spine that is already compromised.

Instead, try exercises that stretch and strengthen the muscles in your upper back, including moderate strength training (without the movements mentioned in the previous paragraph). As with lumbar spinal stenosis, swimming and cycling are excellent low-impact exercises that are safe to do even with narrowing of the cervical spine.

As always, we recommend talking with your doctor before starting any kind of exercise regimen to ensure you’re doing the right activities for your specific condition.

Does acupuncture help spinal stenosis?

Acupuncture is widely used to manage chronic low back pain. Mounting evidence suggests the beneficial effects of acupuncture for mitigating chronic low back pain with acceptable minor adverse events. However, little information exists regarding the effects and safety of acupuncture for degenerative lumbar spinal stenosis, one of the spinal disorders that present chronic low back and leg pain. The investigators aimed to assess the overall effectiveness, safety, and feasibility of acupuncture in combination with usual care (as opposed to usual care alone) for patients with symptomatic degenerative lumbar spinal stenosis.

Can spinal stenosis be reversed?

Spinal stenosis develops over time. It can be caused by degeneration of a number of structures that make up the back. Many of these structural changes are asymptomatic for decades, even though we can see the changes on imaging studies.

As the rigid portions of the spine narrow, symptoms can manifest when the spinal nerves or spinal cord become pinched. Often, pain with spinal stenosis occurs when people walk or stand for long periods of time, causing them to curtail their activities.

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