Spinal stenosis affects over 100 million people worldwide, sometimes having a life-changing impact that can impact a person’s ability to work, social life, and mental health. Before surgical treatments can be considered, a doctor will recommend several non-surgical treatments to help relieve the symptoms and provide a long-term cure.
In this article, we will consider the non-surgical treatments for spinal stenosis including the benefits of physical therapy and exercise, the available medications, and some alternative treatments for you to consider.
What is Spinal Stenosis?
Spinal stenosis is a condition that occurs when the space in the spinal canal becomes too narrow. This results in pressure being applied to the spinal cord and the nerves that run down the spine, resulting in symptoms that include pain, weakness in the legs, tingling or burning sensations, and a possible loss of bowel or bladder control.
Spinal stenosis is most common in the lumbar region of the spine (lower back) but can also occur in the surgical region (the neck). Lumbar spinal stenosis of different spine regions can be cured. Symptoms can vary in severity, and a person should seek medical attention as soon as possible if they experience the symptoms above for a prolonged period.
Non-Surgical Treatments for Spinal Stenosis
Surgery is always considered a last resort for treating any type of back condition. This is why several non-surgical treatment options will be recommended to try and relieve a person from pain, discomfort, and/ or a lack of mobility.
Medications for Spinal Stenosis
A common non-surgical treatment for spinal stenosis is medication, including both prescription medications and those sold over the counter.
Spinal stenosis medications include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – NSAIDs are prescribed to reduce pain and inflammation, with well-known examples including ibuprofen, aspirin, and naproxen.
- Analgesics – This medication does not target inflammation and focuses only on reducing pain. Acetaminophen (Tylenol) is the most common type of analgesic used to treat spinal stenosis.
- Antidepressants – Some antidepressants can be used to treat chronic pain, which can be an extreme symptom of spinal stenosis. The most common antidepressant prescribed for this condition is amitriptyline.
- Anti-seizure drugs – Like antidepressants, some anti-seizure medications can also be used to treat pain. Specifically, pain that is related to damaged nerves.
- Opioids – For severe pain, a doctor may prescribe opioids to provide short-term relief. However, opioids are very addictive and can have a range of negative side effects, which means this medication is rarely issued for long periods. In most cases, if a person’s pain levels do not ease from a course of opioids, a doctor would recommend surgery.
Side Effects of Medications for Spinal Stenosis
Any type of medication can have side effects, with some more severe than others. For example, taking too many NSAIDs can result in stomach issues such as ulcers which is more common among older adults. NSAIDs can also increase the chance of a person suffering a stroke or heart attack. Furthermore, if a person is taking additional drugs, the medications may interact to cause adverse reactions.
As previously discussed, opioids can result in physical dependence if taken over a long period, or tolerance can develop, making them ineffective. Other opioid side effects include nausea, vomiting, sedation, constipation, and possible respiratory depression.
Meanwhile, analgesics can result in the following side effects:
- Damage to internal organs (E.G. the liver or kidneys)
- Heart issues
- Allergic reactions
- Diarrhea or constipation
- Nausea
- Stomach ulcers
- A level of hemophilia makes it difficult for blood clots to form
- A ringing in the ears and even deafness in rare cases
Pain-Killing Injections
As an alternative to medication, a doctor may recommend a person receive pain-killing injections, of which there are two main types for spinal stenosis.
- Corticosteroids – This treatment involves injecting anti-inflammatory steroids into an area close to the spinal cord (epidural injection). This injection works similarly to NSAIDs to reduce pain and inflammation.
- Nerve blocks – Nerve blockers are injected close to damaged nerves to offer pain relief. However, the effects of these injections can vary, with some people enjoying long-term pain relief and others only experiencing a reduction in time for a very short time.
Physical Therapy and Exercise
A doctor will often recommend anyone who has symptoms as a result of spinal stenosis to consider physical therapy. This helps to improve a person’s core strength, flexibility, and mobility, and can also help them to lose weight to reduce pressure on the spine. Each person’s rehabilitation program will vary based on their age, physical condition, and the extent of the damage to the spine.
A physical therapist will typically assist the patient in learning how to safely stretch their back muscles and exercise in a controlled manner. Over time, these exercises will help a person become physically stronger and more flexible, with a more solid muscle core and posture to support the spine. In addition, regular exercise also releases endorphins which act as the body’s natural pain relievers.
Alternative Treatments
In addition to the exercises recommended by a physical therapist, someone suffering from spinal stenosis could also practice yoga, pilates, or tai chi to boost flexibility, muscle strength, and well-being. Other gentle exercises such as taking regular walks, jogging, and swimming can also form part of an overall exercise plan that can promote better spine health and help to manage a person’s weight. Of course, any exercise regime should also be combined with a healthy and balanced diet.
A person may also consider alternative treatments such as acupuncture, chiropractic treatment, or massage therapy. Acupuncture is a traditional Chinese therapy that involves a professional inserting small, flexible needles into specific pressure points on the body. Chiropractic care, on the other hand, is a traction-based treatment that contorts the body to create more space for the nerves.
Thank you for reading. We hope to have provided some insight into treatments that can hopefully relieve any spinal stenosis symptoms and avoid any invasive surgery such as a laminectomy and spinal fusion.