SPINAL STENOSIS

Lumbar spinal stenosis is narrowing of the spinal canal that usually starts gradually and develops over a long period of time. As the spinal canal narrows, it can squeeze (compress) and irritate the nerve roots that branch out from the spinal cord, or it can squeeze and irritate the spinal cord itself.

The goals of treatment for spinal stenosis are to relieve pain, numbness, and weakness in the legs, to make it easier for you to move around (improve function), and to improve your quality of life. Treatment can include pain-relieving medicine, exercises, and other nonsurgical measures, and in some cases, surgical treatment.

Initial treatment

Unless your lumbar spinal stenosis is severe, initial treatment usually is aimed at relieving your symptoms without surgery. Nonsurgical treatment often works to allow most normal activity and relieve mild to moderate symptoms of pain, numbness, and weakness in the legs.

Nonsurgical treatment includes:

Education about the course of your condition and how to relieve symptoms.

Medicines to relieve pain and inflammation, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).

Exercise, to maintain or achieve overall good health. Aerobic exercise-especially riding a stationary bicycle (which allows you to lean forward)-can relieve symptoms.

Weight loss, to relieve symptoms and slow progression of the stenosis.

Physical therapy, to provide education, instruction, and support for your self-care.

Physical therapy helps you learn stretching and strength exercises that may lead to a decrease in pain and other symptoms.

If you have symptoms of cervical spinal stenosis, testing and treatment may be done earlier than in treatment for lumbar spinal stenosis.

The course of lumbar spinal stenosis varies: symptoms may be severe at times, and less severe at other times. If you feel numbness, weakness, or have trouble standing or walking, it may mean that your condition is getting worse. Problems with bladder and bowel control also may mean your spinal stenosis is getting worse.

If you are experiencing a flare-up of severe low back pain that is not relieved by other forms of treatment and you are unable to engage in daily activities, your health professional may prescribe hydrocodone or other opioid medicines. But these medicines do not work well for symptoms that occur in the legs. Also, the side effects of opioids-such as mental confusion, drowsiness, and constipation can be more of a problem than the pain of lumbar spinal stenosis.

ACUPUNCTURE and SPINAL STENOSIS