The location of the spinal stenosis as well as the level of symptoms produced, determine the type of treatment needed. While the general conception is that surgery is the only treatment option, there are numerous other things that can be tried out first.
If your symptoms are mild to moderate, they can be managed with non-surgical treatment modules and regular follow-ups. You might be advised on self-care tips to practice at home. If these don’t help, here are some other non-surgical treatment options:
Physiotherapy and exercise – While exercise or physiotherapy isn’t a cure for spinal stenosis, it helps patients remain active in spite of the restricting pain. In an effort to curtail pain, patients tend to avoid moving, but this can lead to muscle weakness or more pain. Physiotherapy helps in building up strength and endurance while improving balance, flexibility and stability of the spine.
Activity modification – Your doctor and therapist will advise you on the activities that would worsen your symptoms. For example, those with lumbar stenosis are advised to avoid walking completely straight. A little forward bend will make it easier on the patient.
Medications – Different levels of pain-killers can be given. Regular anti-inflammatory medications are often helpful, but in some, they might need to be paired up with short-term narcotics too during times of pain exacerbations. In some cases, muscle relaxants, anti-depressants as well as nerve desensitizers or anti-seizure drugs like Gabapentin might be of additional benefit. Side-effects of medications are always a concern however, especially in the elderly.
Epidural injections – The nerves become irritated and swollen at the point of being pinched. An injection of cortisone into this epidural space can help in reducing inflammation and relieving pain. The steroid injection doesn’t fix the spinal stenosis, but provides a good amount of relief. However, do note that questions have been raised about the long-term effects of repeated steroid injections and weakening of nearby bones and osteoporosis related fractures. Only a few injections/year are advised.
Decompression procedure – It’s also called percutaneous image-guided lumber decompression (PILD) and doesn’t require general anesthesia. The procedure involves removal of the thickened ligament in the back of the spinal column to make more space for the spinal canal and reduce nerve compression and its consequent pain symptoms.
Surgery is the last option used for treating spinal stenosis – in cases where the patient has become disabled by the symptoms. The different types of surgical methods used include lumbar laminectomy, cervical laminectomy, laminotomy and laminoplasty.
When done by an experienced team of doctors – such as that found in the Sita Bhateja Specialty hospital, Bangalore – chances of complications are rare.Leave a reply