Spinal Stenosis Treatment

What Is Spinal Stenosis?

Spinal stenosis is a condition that happens when the spaces in your backbone (vertebrae) become narrowed. When this occurs, your spinal cord and its nerves can get pinched. More than 50% of the time, spinal stenosis affects the lumbar spine, which is the lower part of the back. Narrowing of the spine that goes along with this condition can cause pain that shoots down the back of the leg. It's important to get treatment for spinal stenosis, especially when symptoms like this are present.

Non-Surgical Treatment for Spinal Stenosis

Medications

Few patients who have spinal disorders require surgery on their spine. There are several different spinal stenosis treatment options that your doctor may recommend. Many of these treatments involve a combination of therapies. For instance, your physician may combine physical therapy with a prescription for medication to relieve your pain as a treatment for spinal stenosis approach. Some medications for pain are also available without a prescription.

Over-the-counter Medications

Your spinal stenosis treatment program will probably start with medication unless your symptoms are extremely serious. The main goal of treatment is usually to reduce inflammation and the pain it causes. Analgesics (pain pills) like acetaminophen work to relieve discomfort, but they can't reduce inflammation, so they are not always the first choice for spinal stenosis treatment medications. If you don't have any allergies or other health problems to prohibit their use, your doctor will probably recommend nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen or aspirin. These medications are able to relieve pain and they also decrease inflammation.

Prescription Medications

If over-the-counter medications aren't effectively controlling your pain, the next step your doctor might recommend in your treatment for spinal stenosis is prescription drugs. Muscle relaxants are sometimes prescribed for the pain of spinal stenosis, and medications that are used for other conditions, such as antidepressants and seizure medications are also sometimes beneficial. Part of your treatment for spinal stenosis plan might include prescription-strength NSAIDs to help relieve your pain.

Spinal Injections for pain control

In some severe cases of spinal stenosis, epidural injections of corticosteroids are given directly into the space that surrounds the membrane covering the spinal cord. Corticosteroids are powerful anti-inflammatory agents and administering them at the source of pain may provide pain relief for weeks or even months. Epidural injections are especially helpful as a treatment for spinal stenosis in cases where the pain shoots down the back of the leg. Many patients report almost instant relief. Since steroids are so powerful, they also carry a risk of side effects, some of which are significant. Potential side effects from epidural injections include:

- An increase in pain at the site of the injection

- Fever following the injection

- Anxious feelings

- Weight gain following the spinal stenosis treatment

- Insomnia

- Increased blood glucose levels following the spinal stenosis treatment

- Increased blood pressure (hypertension)

- Lowered immunity

- Peptic ulcers

- Joint damage in large bones, such as in the hip joints

- Cataracts

If you receive an epidural injection as part of your treatment for spinal stenosis, notify your physician right away if:

- Develop a severe headache when you stand or sit up, and the only thing that relieves it is lying down

- Develop severe pain that isn't relieved by typical measures

- Can't control your bowels or bladder

- Experience loss of sensation or function in your legs or arms

Because steroids carry the risk of these dangerous side effects, the number of injections a patient can receive as part of their treatment for spinal stenosis is usually limited. Be sure to discuss the side effects with your doctor.

 

Exercises

When people are having pain, they don't like to think about exercising. However, stretching and exercising are important parts of treatment for spinal stenosis. Moving can help relieve your pain.

Before you begin, make note of the following:

- Talk to your physician before you begin any activity or exercise program as part of treatment for spinal stenosis. Your doctor might have specific recommendations regarding what form of exercise will benefit you the most and may also tell you if there are certain activities to avoid. Your physician is your best source of information.

- Avoid any activity that over-stresses your spine

- Know yourself and pay attention to your body. If your pain gets worse, or if you have new pain, stop your spinal stenosis treatment and call your physician.

Types of Exercise for People with Spinal Stenosis

- Walking is a good exercise for treatment for spinal stenosis. You can vary your pace and walking is low-impact. In addition to being good for your spine, it helps to relieve mental stress. Try to walk every day.

- Swimming is also an excellent treatment for spinal stenosis. It puts all the muscles of the back to work in a safe way. The water serves as a support for your body weight, taking the stress off your spine.

- As part of your spinal stenosis treatment, you can combine swimming and walk-in water-walking

If your physician has recommended physical therapy as part of your spinal stenosis treatment, you will be instructed in stretches and exercises that help build endurance, flexibility and help strengthen your spine. These exercises will also help strengthen the abdominal muscles which will help support your spine.

Physical Therapy

As part of the treatment for spinal stenosis, you may be referred to physical therapy. A skilled therapist can help with pain relief and can also help restore mobility.

Physical therapy includes passive treatment for spinal stenosis to help your body relax and therapeutic exercise which is an active part physical therapy.

Passive treatments you may receive as part of physical therapy might include:

- Deep tissue massage: As part of your treatment for spinal stenosis, massage targets tension in the muscles. Direct pressure and friction are used to help release tension in the body's soft tissues.

- Cold and hot therapies: Heat brings more blood, nutrients, and oxygen to an area to help it heal as part of spinal stenosis treatment. Cold slows blood flow which can help decrease pain, inflammation and muscle spasms. Typically, physical therapists alternate cold and hot therapies.

- Transcutaneous electrical nerve stimulation (TENS): In this spinal stenosis treatment, the muscles are stimulated with safe intensities of electric current. This may interrupt the body's pain signals or stimulate the release of its natural painkillers. TENS is not recommended for treating chronic pain of the lower back.

- Ultrasound: This form of therapy helps reduce pain, swelling, stiffness and muscle cramps as a treatment for spinal stenosis through sound waves that create gentle heat.

Alternative Treatment for Spinal Stenosis

Some people who have spinal stenosis seek the help of a complementary and alternative medicine (CAM) practitioner for treatment for spinal stenosis. CAM therapies and practices are those that are not considered to be a part of conventional treatment at this time. They may include treatments like massage, homeopathy, and acupuncture.

Even though alternative treatment for spinal stenosis isn't considered to be traditional therapies, many people have reported that they have been helped by these treatments. Some of these CAM treatments include:

- Acupuncture: Acupuncture as a treatment for spinal stenosis involves the use of ultra-fine needles inserted through the skin at specific sites in the body. It is based on an Eastern approach to healing that seeks to restore the body's energy force known as the Chi. Some research indicates that acupuncture stimulates the body's release of natural painkillers, known as endorphins.

- Homeotherapy: This practice involves using herbal remedies and medications to reduce inflammation and pain as a treatment for spinal stenosis. Some remedies used in homeotherapy are glucosamine, chondroitin sulfate and hyaluronic acid.

- Massage: Massage may be beneficial as a treatment for spinal stenosis in relieving muscles that are very tense. 

As with any treatment or medication, be sure to speak with your physician before trying any new spinal stenosis treatment to make sure it's safe and appropriate for you.

Surgical Treatment of Spinal Stenosis

Many patients who have spinal stenosis are able to successfully manage their symptoms with non-surgical spinal stenosis treatments. There are some situations though in which surgery becomes necessary. These situations may include:

- If a patient has attempted conservative treatments and they have been unsuccessful

- If a patient has suffered severe pain for a long period of time

- If a patient has pain in the legs or arms, accompanied by numbness and tingling

- If a patient has lost feeling in the legs or arms

- If a patient has weakness or loss of function in the legs or arms

- If a patient has lost control of their bladder or bowels

One of the primary goals of surgical spinal stenosis treatment is to provide more room in the spinal canal for the nerve roots and the spinal cord. By making the spinal canal larger, it is hoped the pain caused by inflammation of the nerve will subside.

Another goal of surgical spinal stenosis treatment is to increase strength in your extremities and restore feeling in the legs or arms if this has been impaired. There are typically two different types of surgeries that are used in the treatment of spinal stenosis:

- Decompression: During this procedure, the tissue that is compressing the nerve or spinal cord is removed. This creates more room in the spinal canal.

- Stabilization: In this procedure for treatment for spinal stenosis the amount of movement between the bones of the spine is limited.

Decompression Surgery for the Treatment of Spinal Stenosis

Different types of surgery can be performed for decompression, depending on what is compressing a nerve. The types of procedures used as spinal stenosis treatments for decompression include:

- Foraminotomy: In this operation, a bone spur or part of a vertebra is removed where the nerve exits the spine to make this opening larger.

- Laminotomy: As part of a surgical spinal stenosis treatment, this operation removes a portion of a vertebra called the lamina to make more room in the spinal canal.

- Laminectomy: This is similar to a laminotomy, but rather than just a portion of the lamina being removed, the entire lamina is taken out. 

If indirect decompression is performed, pressure on the spinal cord or nerve roots is removed by moving bones apart, rather than by removing bone as spinal stenosis treatment.

Stabilization Surgery for Spinal Stenosis

If one or more vertebrae move out of their correct alignment, the spine can become unstable in addition to becoming painful. Bones that slip out of position can pinch nerves. As part of spinal stenosis treatment in these cases, spinal fusion or stabilization surgery may be necessary. The need for this procedure depends on how many vertebrae have slipped, and also on how extensive of operation you require as part of your spinal stenosis treatment. If your surgeon needs to perform a laminectomy on several vertebrae, for example, your spine will become very unstable without spinal fusion.

Spinal fusions have been common for several years. The procedure can be done with decompression surgery, or it can be done alone as a separate operation. A bone graft is inserted along with spinal instrumentation to help the bones grow together. The fusion provides spinal stability by preventing movement between the bones of the spine.

Open Spine Surgery or Minimally Invasive Spine Surgery?

Spinal stenosis treatment can be performed in some cases using minimally invasive techniques. This means the surgery is completed using several small openings, rather than a large incision. The surgeon uses very small instruments, a tiny camera or a microscope or endoscope to operate. Minimally invasive surgery is not always an option. If several vertebrae need to be worked on, open surgery will most likely be needed for your surgical spinal stenosis treatment.

Risks of Surgery

If you have surgery as part of your spinal stenosis treatment, be sure to discuss the possible complications with your physician. Possible complications may include:

- Complications related to the use of anesthesia,

- Damage to your spinal nerves or spinal cord,

- Failure of the fusion to heal,

- Continued pain after surgery,

- Failure or breakage of the instrumentation,

- Infection.

Recovery After Spinal Stenosis Surgery

If you have surgery as a spinal stenosis treatment, chances are you will not feel better immediately. You will be helped to get out of bed within the first 12 to 24 hours and you will most likely be on pain medications for several weeks. Your surgeon will give you specific instructions related to safety and how to stand, sit, and get up and down. You probably will need to restrict your activity for several weeks.

- You should not lift anything and avoid twisting, bending or reaching.

- Be sure to report any increased pain, fever or signs of infection to your doctor,

- Practice good posture,

- Maintain a healthy weight,

- Follow a healthy diet,

- Don't smoke,

- Avoid excessive alcohol use.

Surgery as a spinal stenosis treatment is usually successful. In fact, up to 90% of patients obtain pain relief!

You might also like to read:
- Corpectomy,
- Discectomy.

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Questions & Answers
Q:
What is the best way to treat permanent back and neck pain and stiffness?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Use a telephone headset

Never hold a phone between your shoulder and your ear. Use a headset or other hands-free system to talk on the phone and avoid abusing your neck and spine.

Neck Pain Tips: Exercise your neck muscles

One of the best neck pain tips is using the chin tuck. You can do this often throughout the day. In addition to helping strengthen the muscles that hold the head in alignment over the shoulders, it also helps strengthen the scalene and sub-occipital muscles.

Read more tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

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Temed Holdings
4 answers
Q:
What is the best treatment for neck pain and shoulder Pain?
A:

One of the best treatment for neck pain and shoulder pain is exercises:

Neck Pain Exercises: Neck Extension

  1. To begin this neck pain exercise, sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the palm of your hand on the back of your neck, at the base of your head
  4. Apply slight forward pressure with your hand, while resisting the forward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax
  6. Repeat the neck pain exercises 5-10 times

Neck pain exercises: Side bend

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place your left hand, palm down, on the left side of your head (around your ear)
  4. Slightly push your head to the right side with your hand, while resisting the sideways motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat 5-10 times
  7. Repeat the neck pain exercises with the other side.

Neck pain exercises: Neck flexion

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the tips of your fingers on your forehead
  4. Slightly push your head backward with your fingers, while resisting the backward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat the neck pain exercises 5-10 times

More exercises here: Neck Pain Exercises

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Temed Holdings
4 answers
Q:
How do I reduce the shoulder and neck pain?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Carry weight evenly

Many people make the mistake of carrying a heavy briefcase or their purse on their shoulder or on one side of their body. Doing this causes strain in the muscles and leads to pain.

Remove non-essentials from your briefcase or purse. Consider using a backpack to evenly distribute the weight across your shoulders. If you choose to carry a purse or backpack, keep your shoulders level while carrying it.

Neck Pain Tips: Maintain a proper posture

The most common posture contributing to neck pain is the “head-and-shoulders-forward” posture. In this position, the neck slopes forward, putting the head in front of the shoulders.

In this position, the head pulls the upper back forward also in a slumped position. This places a strain on the entire spinal column.

More tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

Read more
Temed Holdings
4 answers