For better or worse, physical pain is a part of life as we grow older. Pain is our body’s way of communicating that something is wrong and that it needs attention. When ignored, too much pain can cause further health problems like anxiety, depression, and poor mobility. Back pain resulting from spinal stenosis is no exception. Depending on the severity of the condition, non-surgical treatments can often be effective at managing the pain.
What is Spinal Stenosis?
Spinal stenosis, or cervical spinal stenosis, is a narrowing of the canal in your spinal column that mainly affects people aged 50 and older. Although nothing can cure spinal stenosis, there are things you can do on your own— under a doctor’s guidance— to enjoy an active lifestyle.
Symptoms that are even more noticeable during the final stages of spinal stenosis may include:
- Numbness or tingling in the arms or legs
- Weakness in your arms, legs, or feet
- A loss of coordination and balance problems
- Walking problems
- Loss of bowel and bladder control
- Lower back or neck pain
What Causes Spinal Stenosis?
While most common in older patients due to the general aging of the spine, spinal stenosis can also be genetic or accelerated by specific injuries and medical conditions.
Common causes of cervical spinal stenosis include:
- Congenital stenosis (being born with a narrow spinal canal.)
- Spondylolisthesis (slipped vertebra)
- Injuries, surgery, or trauma to the spine
- Osteoarthritis (bone spurs)
- Bulging or herniated discs
- Spinal tumors
As there is no cure for spinal stenosis, early detection and treatment of the root cause can provide significant pain relief and improve existing symptoms. So, how do you fix spinal stenosis without surgery? What follows are some of the best non-surgical lumbar spinal stenosis treatments.
The natural reaction to back pain is to lessen physical activity because you think it might worsen your symptoms. However, a physical therapist can show you spinal stenosis exercises that reduce your pain by strengthening your back and core muscles. These forms of exercise help slightly modify the spine’s lumbar curvature in a way that opens the spinal canal.
A physical therapy program can go a long way towards easing your symptoms while also helping you improve your balance, flexibility, and endurance. In addition to physical therapy, other alternative treatments for spinal stenosis may include chiropractic care and integrative therapies.
One of the primary methods of treatment that chiropractors use to minimize spinal stenosis symptoms is spinal manipulation. This technique uses gentle hand movements to change the positions of the vertebrae of the spine ever-so-slightly. Spinal manipulations take the pressure off the spine, helping to relieve pain and discomfort.
Examples of integrative therapies for cervical spinal stenosis include heat, massage, meditation, and acupuncture. Transcutaneous electrical nerve stimulation (TENS), which uses a low-voltage electrical current to stimulate the production of endorphins— the body’s natural pain relievers— may also be an option.
Regular exercise, taking steps to correct poor posture, losing weight, radiofrequency ablation, and wearing a back support belt are other examples of integrative treatments used to relieve pain resulting from spinal stenosis.
Things to avoid with cervical spinal stenosis include a lack of physical exercise, poor posture, ignoring the pain, and repetitive lifting and twisting (notably heavy objects).
Notably, for older patients, it is advisable to avoid activities that worsen spinal stenosis symptoms. For lumbar stenosis, patients are typically more comfortable while flexed forward. For example, a recommended activity modification might include walking while bent over and leaning on a walker or shopping cart instead of walking upright.
What is the best pain killer for spinal stenosis? That’s hard to say because a “one-size-fits-all” approach doesn’t work for every patient. These oral over the counter (OTC) and prescription medications are commonly used to treat spinal stenosis:
Nonsteroidal anti-inflammatory drugs (NSAIDs) – These reduce pain and inflammation and include OTC NSAIDs like aspirin, naproxen (Aleve), and ibuprofen (Motrin, Advil).
Analgesics – These OTC medications work on the central nervous system and help relieve pain but not inflammation. Acetaminophen (Tylenol) is the most common analgesic used for lumbar spinal stenosis.
Antidepressants – Chronic back and neck pain resulting from spinal stenosis can cause anxiety and depression. Doctors sometimes prescribe tricyclic antidepressants like amitriptyline to improve a patient’s sense of wellbeing.
Anti-seizure drugs – Your doctor may prescribe these to help with pain, numbness, or tingling caused by damaged nerves. Examples of anti-seizure medications used to treat lumbar stenosis include gabapentin and pregabalin.
Oral corticosteroids – Corticosteroids are anti-inflammatory medications that can reduce swelling and irritation in the nerves and spinal cord, relieving pain. Doctors typically prescribe a course of corticosteroids taken by mouth for five or six days and reassess your symptoms before recommending further treatment. Some patients experience relief from arm or leg pain within a few days.
Neuroleptics – When taken by mouth, neuroleptic medications stabilize overactive nerve cells (neurons) within the spinal cord, relieving arm or leg pain associated with nerve compression. How neuroleptics relieve this pain is not well understood, but some patients find that taking a neuroleptic every day by mouth relieves discomfort caused by spinal stenosis.
Note: All medications, including over-the-counter meds, can cause side effects. Always check with your doctor before taking any medications, even those that don’t require a prescription.
Epidural Steroid Injections
During an epidural or transforaminal spinal injection, a physician uses X-ray guidance and contrast dye to inject a long-acting corticosteroid medication into the spaces around the compressed spinal nerves. A local anesthetic is injected before the corticosteroid to help reduce pain while the procedure is being performed. Corticosteroid injections work to decrease inflammation and reduce pain. This relief can last for weeks to months, depending on the patient.
In a nerve block, a doctor injects the area around the nerve with a numbing medicine, or anesthetic. Lidocaine is the anesthetic that’s used most often. After a nerve block injection, you’ll quickly have numbness with near-complete pain relief. It wears off after several hours.
What is a Decompression Procedure?
Although the efficacy of non-surgical spinal stenosis treatments is usually good, it may become necessary to undergo a surgical procedure known as a lumbar laminectomy or spinal decompression. Performed by an orthopedic surgeon, a decompression procedure involves the removal of all or part of the lamina (posterior part of the vertebra) to provide more space for the compressed spinal cord and/or nerve roots.
How The Spine Center Can Help
At The Spine Center, we’re dedicated to providing you with high-quality, personalized back and neck care. We strive to offer efficient and professional services to our patients, delivered with integrity and honesty in a cohesive, family-like environment. We have a solid commitment to excellence in diagnosing and treating spinal injuries and conditions spanning all age groups.
As fellowship-trained physicians with over 50 years of experience treating spinal conditions, we offer patient recommendations for treatment, including conservative care, non-operative treatment, and sophisticated, customized surgical solutions. Our physicians serve as innovators in technology, actively participate in national and international research studies, and are at the forefront of medical knowledge. If you or a loved one suffer from back or neck pain, call The Spine Center today at (847) 628-8147 to schedule a consultation.