Spinal Stenosis Treatment

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Spinal stenosis diagnosis

When considering how to treat spinal stenosis, you must begin with an accurate diagnosis. The most frequent symptom encountered when diagnosing spinal stenosis is leg pain that worsens when the patient walks. There may or may not be back pain associated with this leg pain. When a patient presents these symptoms to their general practitioner a conclusive diagnosis can be formed with the assistance of a MRI or CT scan with myelogram. A physical examination alone will not be able to provide enough evidence for a conclusive diagnosis.

A key to successful treatment is an accurate identification of the type of spinal stenosis the patient is suffering from. The following are three major types of spinal stenosis.

Lateral Stenosis - Once the nerve has exited the spinal canal it can be compressed by either a bone spur, bulging disc, or herniated disc. This is call Lateral stenosis and is the most common form of spinal Stenosis.

Central Stenosis - The cauda equine (horse’s tail) is a bundle of loose nerve filaments. When the sack that contains these nerves is compressed it is termed central spinal stenosis. This form of spinal stenosis is most common at the second from the lowest lumbar spinal level and higher. This is most commonly caused by bulging disc or an overgrowth of ligament which is there to help protect the dura. A degenerating disc will often cause this overgrowth.

Foraminal Stenosis - As the nerve root is about to leave the canal through a side hole (lateral foramen); a bone spur (osteophyte) that has already developed from a degenerating disc can press on that nerve root. 72% of cases of foraminal stenosis occur at the lowest lumbar level, trapping the emerging nerve root (which comprises a major part of the sciatic nerve).

Spinal stenosis treatment

Conservative treatments for spinal stenosis may include:

Activity modification - Most patients suffering from spinal stenosis will usually feel more comfortable flexed forward. The discomfort of walking can be eased by leaning on a cane, walker or shopping cart.
Exercise: Although exercise is not considered a cure, a physical therapist with a suitable exercise program can help to prevent any further debilitation that arises from inactivity. For obvious reasons that we have already covered, being seated and flexed forward on a stationary bike can be a good choice of exercise.
Non-steroidal anti-inflammatory drugs (NSAIDs): A common symptom of spinal stenosis is inflammation. Anti-inflammatory drugs, such as ibuprofen or aspirin, may be helpful in treating spinal stenosis.
Epidural injections: It usually takes about fifteen to thirty minutes for these injections and they are administered in an out-patient setting. A needle is guided into the epidural space and once in position, the solution is slowly injected. Epidural injections use steroids as an anti-inflammatory agent, and often include a fast-acting local anesthetic for temporary pain relief.

Most spinal stenosis cases will not require surgery and it is generally an elective procedure. It is up to the patient to decide when they have grown tired of dealing with the restrictions placed on their activities and seek surgical treatment. If you would like more information we suggest you take a look at our page dedicated to spinal stenosis surgery where we examine this topic closer and go into further detail.

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