Lumbar Spinal Stenosis - Treatment

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What kinds of treatment, therapy, or medication did you receive for lumbar spinal stenosis?

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What is the treatment for lumbar spinal stenosis?

In most situations, the treatment for lumbar spinal stenosis begins with conservative (nonoperative) treatments. This can include medications to reduce inflammation, even short courses of oral cortisone medication, and pain medications. There are also several medications directed specifically at nerve pain that are helpful in lumbar spinal stenosis, including gabapentin (Neurontin) and pregabalin (Lyrica). Physical therapy can help for many. Cortisone (steroid) injections in the lumbar spine, referred to as epidural injections, can also reduce the symptoms by decreasing inflammation and swelling around the nerve tissue. These are sometimes repeated up to three times per year.


Surgery may be indicated for those who do not improve with the above treatments or if there is severe or progressive weakness or loss of bowel or bladder function (cauda equina syndrome). Depending on the examination findings and imaging studies, there are various surgical procedures available to treat lumbar spinal stenosis, ranging from laminectomy to fusion procedures.

The main goal of surgery is to remove the structures that are compressing the nerves in the spinal canal or vertebral foramen. This is referred to as lumbar decompression surgery (laminectomy, laminotomy, foraminotomy). In some patients, this can be performed alone, but in other patients, it must be combined with lumbar fusion. If too much of the compressive structures need to be removed to free the nerve, the vertebrae may become unstable (spinal instability). This leaves the vertebrae with abnormal motion. If this occurs, a spinal fusion can be performed to attach the vertebrae together and eliminate the motion at that level. Sometimes this requires metallic hardware to be installed in the vertebrae to adequately support and fix the involved bone.

Surgery for lumbar spinal stenosis can be very successful in most patients in relieving the leg symptoms of ambulatory pain, sciatica, and numbness. However, depending on the severity of the nerve compression and the length of time the nerve have been compressed, there may be some permanent damage that is not relieved with surgery. The success for back pain relief is less reliable with surgery than the relief of leg symptoms.

More recently, surgical procedures that are somewhat less invasive than traditional lumbar decompression have become available. Interspinous devices that have been used in certain patients for this purpose include X-Stop and Coflex devices.

Return to Lumbar Spinal Stenosis

See what others are saying

Comment from: Maureen, 75 or over Female (Patient) Published: December 06

I have had spinal stenosis for the last three years. I have had numerous spinal injections of cortisone, the last being a lumbar epidural. None have worked. I have been using a morphine patch for the last couple of years, going from 5g to 10mg. I am still in constant pain and cannot walk very far before having to sit down because of pain down my leg. I am now taking Lyrica tablets for the pain, but they do nothing. I have gone from playing golf three times a week, to sitting down for most of the day and rapidly gaining weight!

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Comment from: April, 55-64 Female (Patient) Published: July 23

I was recently diagnosed via an MRI and numerous x-rays, with spinal stenosis. My treatment so far has been physiotherapy (PT), gabapentin, tramadol, and ibuprofen. Gabapentin has provided significant pain relief so I am able to sleep some each night, go to PT, and go to the store (using a shopping cart). My stamina is not there, and I am limited in how many minutes I can walk around the store, but at least it's some improvement. I do have an appointment on Friday with a doctor who administers the epidural steroid injections (ESI). I am really afraid of these, so I will be asking a lot of questions, and speaking up about having a sedative before they even start the ESI.

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