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

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 make the vertebrae attached 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.

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See what others are saying

Comment from: hearkittycat, 75 or over Female (Patient) Published: November 01

Thirty years ago I had 2 slipped discs in lower back because of lifting. Lots of walking, increasing distances and rest therapy got me well in near a year's time. I had a few relapses of short duration and this year from taking a bus tour for a month, climbing in and out of the bus, I have had a rough time getting well again. I swim every day but I can't walk far without sitting and resting. I sometimes have pain in my knees then in the groin. The pain moves around. I have some loss of control over the bladder at times. Bowel movements help the pain to subside. I'm not seeking medical attention since I am getting better by degrees with swimming, resting and taking aspirin when I need it. It's been 5 months and I expect it will take 5 more months.

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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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