Depending on the severity of symptoms, spinal stenosis can often be managed through non-surgical treatments.
The three most common non-surgical spinal stenosis treatments include:
- Activity modification
- Epidural injections
Non-surgical Treatment for Spinal Stenosis
Non-surgical spinal stenosis treatment options for patients may include:
- Exercises. Although a suitable program of spinal stenosis exercises may be helpful in the hands of a good physical therapist, it is not curative. Even though stenosis exercises are not a cure, however, it is very important for patients to remain active as tolerated and not additionally debilitated from inactivity; therefore, an appropriate spinal stenosis exercise program is a key part of any treatment program.
- Activity modification. With this treatment for stenosis, patients are usually counseled to avoid activities that cause adverse spinal stenosis symptoms. Patients are typically more comfortable while flexed forward. Examples of activity modification for treatment of spinal stenosis might include: walking while bent over and leaning on a walker or shopping cart instead of walking upright; stationary biking (leaning forward on the handlebars) instead of walking for exercise; sitting in a recliner instead of on a straight-back chair.
- Epidural injections. An injection of cortisone into the space outside the dura (the epidural space) can temporarily relieve symptoms of spinal stenosis. While injections can seldom be considered curative, these spinal stenosis treatments can alleviate the pain in about 50% of cases. Up to three injections over a course of several months can be tried. Although they are not considered diagnostic in and of themselves, generally, if the pain caused by spinal stenosis is relieved by an epidural steroid injection, then the patient can also be expected to have a good result if they later choose to have spinal stenosis surgery.
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Additional Treatments for Spinal Stenosis
Anti-inflammatory medication (such as aspirin or ibuprofen) may be helpful in treating spinal stenosis. Some physicians recommend a multiple B-complex vitamin with 1200 mcg of folic acid daily, but this has not been substantiated in the medical literature as an effective treatment for stenosis.
Some people may successfully manage the symptoms of spinal stenosis with the non-surgical therapies either for a period of time or indefinitely. The key in choosing whether or not to have surgery is the degree of physical disability and disabling pain from lumbar spinal stenosis.
As a guideline, when the (usually elderly) patient can no longer walk sufficiently to care for himself or herself (such as to go shopping for essentials), then lumbar spinal stenosis surgery is usually recommended. Surgery for lumbar stenosis is mainly designed to increase a patient’s activity tolerance, so he or she can do more activity with less pain.